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心房颤动与胁腹疼痛:考虑肾梗死:一例报告

Atrial fibrillation and flank pain: Think renal infarction: A case report.

作者信息

Mohamed Aden Fatouma, Djafarou Boubacar Raynatou, Ekhya Amoumoune Fatima, Atteyeh Sougal Moustapha, Diallo Thierno Hamidou, Faraj Raid, Mouine Najat, Benyass Aatif

机构信息

Cardiology Center, Mohammed V Military Training Hospital, Rabat, Morocco.

Department of Cardiology A, Ibn Sina University Hospital, Rabat, Morocco.

出版信息

Radiol Case Rep. 2024 Jul 1;19(9):3946-3948. doi: 10.1016/j.radcr.2024.05.061. eCollection 2024 Sep.

Abstract

Renal infarction is a rare pathology, threatening the functional prognosis of the kidney. Given the lack of clinical features specific to this pathology, the practitioner may wrongly diagnose pyelonephritis or other causes of abdominal pain. Renal infarction frequently occurs in patients with thromboembolic risk factors, most often secondary to atrial fibrillation. We report the case of a 49-year-old patient, with no previous history, who presented to the emergency room with palpitations and pain in the right flank with an atrial fibrillation rhythm on the ECG, in whom abdominal CT angiography showed signs of a focal renal infarction of the right kidney. Later, the progression was towards non-traumatic macroscopic hematuria with preservation of normal renal function, which resolved spontaneously after a few days. AF was accepted in the face of significant dilatation of the left atrium, in consultation with the patient, and he was put on a beta-blocker to control the rate. Renal infarction must be considered despite its rarity to initiate adequate treatment and increase the chances of renal rescue.

摘要

肾梗死是一种罕见的病理情况,会威胁到肾脏的功能预后。鉴于缺乏该病理情况的特异性临床特征,医生可能会误诊为肾盂肾炎或其他腹痛原因。肾梗死常发生于有血栓栓塞危险因素的患者,最常见于继发于房颤。我们报告一例49岁患者,既往无病史,因心悸和右侧胁腹疼痛就诊于急诊室,心电图显示房颤心律,腹部CT血管造影显示右肾局灶性肾梗死迹象。后来,病情进展为非创伤性肉眼血尿,肾功能正常,几天后自发缓解。经与患者协商,鉴于左心房明显扩张,接受了房颤诊断,并给予β受体阻滞剂控制心率。尽管肾梗死罕见,但必须考虑到它,以便启动适当的治疗并增加挽救肾脏的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2438/11266867/3a009cc9f16a/gr1.jpg

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