Im Chami, Park Hyung Sub, Kim Dae Hwan, Lee Taeseung
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Vasc Specialist Int. 2016 Dec;32(4):195-200. doi: 10.5758/vsi.2016.32.4.195. Epub 2016 Dec 31.
Spontaneous renal artery dissection (SRAD) is a rare disease entity. The diagnosis is usually delayed because clinical presentation is non-specific. We report three cases of symptomatic SRAD complicated by renal infarction which occurred in previously healthy middle-aged male patients. They visited the hospital due to acute abdominal or flank pain. They had no specific underlying disease or trauma history. The laboratory tests and physical examination were normal. They were not suspected of having SRAD initially, but computed tomography (CT) revealed dissection of the renal artery with distal hypoperfusion leading to renal infarction. They were treated conservatively with anticoagulation and/or antiplatelets for 6 months. They had a 6-month regular follow-up with CT, where resolution was confirmed in one patient and all patients remained asymptomatic. These cases emphasize the importance of clinical suspicion of SRAD in previously healthy patients who complain of abdominal pain without specific findings on initial investigation.
自发性肾动脉夹层（SRAD）是一种罕见的疾病实体。由于临床表现不具特异性，诊断通常会延迟。我们报告了3例有症状的SRAD合并肾梗死的病例，这些病例发生在既往健康的中年男性患者中。他们因急性腹痛或胁腹痛就诊。他们没有特定的基础疾病或外伤史。实验室检查和体格检查均正常。最初他们未被怀疑患有SRAD，但计算机断层扫描（CT）显示肾动脉夹层伴远端灌注不足导致肾梗死。他们接受了6个月的抗凝和/或抗血小板保守治疗。他们接受了为期6个月的CT定期随访，其中1例患者证实病变消退，所有患者均无症状。这些病例强调了对于既往健康、主诉腹痛但初始检查无特异性发现的患者，临床怀疑SRAD的重要性。
