SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY 13210, United States.
Am J Emerg Med. 2018 Jul;36(7):1325.e1-1325.e2. doi: 10.1016/j.ajem.2018.04.018. Epub 2018 Apr 19.
Acute renal infarction is a relatively rare and scarcely reported condition. Contrast enhanced CT scan is essential for diagnosing this condition. The most common etiology of this condition is cardioembolic, however up to 59% of cases could be classified as idiopathic acute renal infarction. Here we present a case of a 41 year-old male who was admitted for acute onset right flank pain with fevers and rigors. A CT abdomen with contrast showed findings concerning for right pyelonephritis or renal infarction. Urinalysis was negative for infection. He did not respond to treatment with intravenous antibiotics and was thus diagnosed with acute renal infarction. Work-up for common etiologies was negative and the renal infarction was presumed to be idiopathic. He was discharged home on Enoxaparin. In conclusion, acute renal infarction is a rare condition which should be suspected in patients presenting with acute flank/abdominal pain in whom the more common etiologies have been ruled out.
急性肾梗死是一种相对罕见且报道较少的疾病。增强 CT 扫描对诊断这种疾病至关重要。这种疾病最常见的病因是心源性栓塞，但多达 59%的病例可归类为特发性急性肾梗死。在这里，我们介绍一例 41 岁男性，因突发右侧腰痛伴发热和寒战而入院。腹部 CT 增强扫描显示右侧肾盂肾炎或肾梗死的表现。尿液分析未发现感染。他对静脉用抗生素治疗没有反应，因此被诊断为急性肾梗死。常见病因的检查均为阴性，肾梗死被认为是特发性的。他出院时给予依诺肝素治疗。总之，急性肾梗死是一种罕见的疾病，对于那些已排除常见病因且出现急性腰痛/腹痛的患者，应怀疑该病。
