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一名健康年轻女性患者因钝性创伤导致双侧肾梗死:病例报告

Bilateral Renal Infarcts Due to Blunt Trauma in a Healthy Young Female Patient: A Case Report.

作者信息

Locklear Taylor, McMandon Alyssa, Daley Rachel A, Biswas Saptarshi

机构信息

Surgery, Grand Strand Medical Center, Myrtle Beach, USA.

Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA.

出版信息

Cureus. 2025 May 2;17(5):e83366. doi: 10.7759/cureus.83366. eCollection 2025 May.

Abstract

Bilateral renal infarcts due to blunt trauma in the absence of underlying pathology are a rare condition. Trauma-induced renal infarction occurs due to decreased perfusion to the renal system. A 23-year-old woman with no significant past medical history presented to the emergency department with abdominal pain after being struck by a car as a pedestrian. She reported abdominal pain, shoulder pain, and pelvic pain. Imaging revealed multiple traumatic injuries, including a right shoulder dislocation, vertebral and pelvic fractures, and bilateral renal infarcts. Extensive workup, including echocardiography, renal ultrasound, magnetic resonance angiography, and hypercoagulability testing, was unremarkable. The findings were attributed to transient renal hypoperfusion secondary to trauma-related vascular dysfunction. Her symptoms resolved with conservative management, and she was discharged with outpatient follow-up. Renal infarcts are most commonly due to cardioembolic events, and trauma-induced renal infarcts are rare and typically result from hypoperfusion, vasospasm, or vascular injury. Contrast-enhanced CT imaging is used to diagnose renal infarcts. Most trauma-related cases of renal infarcts resolve spontaneously without any complications. This case highlights a rare instance of bilateral renal infarction after blunt abdominal trauma. Further research is warranted to discuss the clinical significance of and long-term outcomes of transient renal hypoperfusion in trauma patients.

摘要

在无潜在病理状况的情况下,钝性创伤导致的双侧肾梗死是一种罕见病症。创伤性肾梗死是由于肾系统灌注减少所致。一名23岁无重大既往病史的女性行人被汽车撞击后因腹痛就诊于急诊科。她自述有腹痛、肩部疼痛和骨盆疼痛。影像学检查显示多处创伤性损伤,包括右肩关节脱位、椎骨和骨盆骨折以及双侧肾梗死。包括超声心动图、肾脏超声、磁共振血管造影和高凝状态检测在内的全面检查均无异常。这些发现归因于创伤相关血管功能障碍继发的短暂性肾灌注不足。她的症状经保守治疗后缓解,出院并安排了门诊随访。肾梗死最常见的原因是心脏栓塞事件,创伤性肾梗死很少见,通常由灌注不足、血管痉挛或血管损伤引起。增强CT成像用于诊断肾梗死。大多数与创伤相关的肾梗死病例可自发缓解且无任何并发症。本病例凸显了钝性腹部创伤后双侧肾梗死这一罕见情况。有必要进一步研究探讨创伤患者短暂性肾灌注不足的临床意义及长期后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2cf/12127146/9576d8e63d73/cureus-0017-00000083366-i01.jpg

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