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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal infarction is most frequently due to emboli from the heart or aorta. Other causes include atheromatous disease, renal artery aneurysm, vasculitis, hypotension, hypercoagulable states, aortic dissection, and major trauma. Most renal infarctions are segmental. The extent of disease is dependent upon the size and number of renal vessels involved, coexistent renal disease, and collateral circulation. Flank pain, fever, leukocytosis, hematuria, renal failure, or hypertension may suggest the diagnosis, but these findings are nonspecific and diagnosis will depend not only on history and physical examination, but also on the appropriate imaging tests. The type of treatment is dictated by the etiology of the infarction.
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PMID:Renal infarction after aerobics. 639 75

Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation.
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PMID:Acute renal infarction secondary to atrial fibrillation - mimicking renal stone picture. 1690 29

Renal infarction is a rare cause of acute abdominal and flank pain. Whether it occurs due to thrombosis or embolism, the occlusion of the renal arteries always results in renal infarction. Cigarette smoking is a known risk factor for arterial thrombosis. Both vasoconstrictor and pro-thrombotic effects of smoking lead to arterial thrombosis. Herein, we report a case of acute renal infarction in a heavy smoker. The definite diagnosis was made by contrast-enhanced abdominal computerized tomography and renal arteriography.
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PMID:Acute renal infarction in a heavy smoker. 1737 64

The administration of antineoplastic agents are associated with various vascular events. A case of acute bilateral renal infarction in a patient with non-small cell lung carcinoma during chemotherapy with cisplatin and gemcitabine is reported. The patient was misdiagnosed as having renal colic. To our knowledge, bilateral renal infarction following cisplatin and gemcitabine has not been reported previously. Renal infarction should be considered in the differential diagnosis of flank pain in a patient treated with gemcitabine and cisplatin.
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PMID:Bilateral renal infarction in a patient with lung carcinoma treated with cisplatin and gemcitabine. 1799 62

The clinical presentation of acute onset of nausea, vomiting, and flank pain in combination with acute elevation of blood pressure should raise high suspicion of renal infarction. However, because of its nonspecific presentation, diagnosis may be delayed. We report the case of a 63-year-old man who presented with a 2-day history of right flank pain that was treated initially as a renal stone. He had a background history of atrial fibrillation. Further investigations confirmed this as a case of renal infarction. Renal infarction is underdiagnosed because of the similarity of its presentation to other renal pathology. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation.
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PMID:Considerations in the diagnosis and therapy for acute loin pain. 1937 55

Renal infarction is an uncommon finding at autopsy most often related to occlusive thromboembolism or to trauma. A 42-year-old woman is reported who presented with persistent right flank pain after an alleged assault with injury to the area 3 weeks previously. Renal infarction necessitated a right nephrectomy that was followed by multiorgan failure and death. Given the possible link between the assault and the renal pathology, a homicide investigation was initiated. Although renal infarction had been confirmed by hospital pathologists, microscopy with special staining of both kidneys and the heart after autopsy revealed multifocal areas of angioinvasion by fungi having morphologic characteristics of mucormycosis. The only other finding of significance was alcohol-related micronodular cirrhosis of the liver. Renal infarction had therefore been caused by an angioinvasive fungal infection predisposed to by immunocompromise associated with alcoholism and not by trauma-induced arterial dissection. This case demonstrates that careful histological assessment of tissues from medicolegal autopsies may occasionally identify unexpected and rare disorders that have been confused with the sequelae of inflicted injury.
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PMID:Disseminated fungal infection with renal infarction simulating homicide. 2093 25

Fibromuscular dysplasia (FMD) is an uncommon disorder, accounting for less than 10% of cases of renal artery stenosis, and typically presenting with hypertension in young women. This article reports the case of a previously healthy 37-year-old man presenting with acute-onset, severe, bilateral flank pain. Initially treated for ureteral colic and urinary tract infection, he was transferred to the nephrology clinic upon recognition of a rising serum creatinine. He was found to have FMD of bilateral renal arteries with a stenotic pattern on the right side and a dissecting aneurysm on the left side with resultant infarctions in both kidneys. On the basis of negative serological markers of vasculitis, a diagnosis of FMD complicated by bilateral renal infarctions was made. A stent was placed to the right stenotic renal artery, which resulted in sufficient lumen patency. No invasive procedure was performed on the other side owing to the complexity of the lesion. After 2.5 years of follow-up, the patient remained in good condition with normal renal function and adequate blood pressure control with dual antihypertensive therapy. Renal infarction complicating FMD of renal arteries is rare in the literature, with most of the cases having causative cardiovascular risk factors including coagulopathy, ischaemic heart disease, atrial fibrillation or structural cardiac abnormalities, none of which was present in this case. In conclusion, FMD may occur in atypical asymmetric presentations causing renal infarctions in both kidneys. Radiological interventions in such cases should focus on stabilizing renal lesions and renal function.
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PMID:Bilateral renal infarctions complicating fibromuscular dysplasia of renal arteries in a young male. 2162 38

A 52-year-old unvaccinated and splenectomized man presented with fever, altered sensorium, bilateral flank pain and chest discomfort accompanied with paroxysmal atrial fibrillation with a rapid ventricular response. An abdominal computed tomography scan was performed, which revealed a right renal infarct and splenosis. Transthoracic echocardiography was performed, which demonstrated an echodense structure on the mitral valve with mitral regurgitation and a vegetation on the aortic valve with aortic regurgitation. Subsequently, he was found to have pneumococcal infective endocarditis, pneumococcal pneumonia and bacterial meningitis, namely Austrian syndrome. He underwent an early aortic valve and mitral valve repair but still had a poor clinical outcome. Renal infarction has a mortality of approximately 13.2%, which is strongly influenced by the underlying diseases and infectious complications. Medical and surgical treatment initiated in a timely manner is often inadequate. The authors report the first case of Austrian syndrome presenting with renal infarction as a clue to an embolic event associated with infective endocarditis in this study.
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PMID:Renal infarction as a presentation of Austrian syndrome: thromboembolic phenomenon of pneumococcal endocarditis. 2273 59

Renal infarction (RI) is rare, and usually occurs in patients with associated comorbidities. The majority of reported cases have presented with laboratory abnormalities, most notably leukocytosis and elevated lactate dehydrogenase (LDH). A 50-year-old active duty white male nonsmoker without medical history presented with flank pain. Urinalysis, complete blood count, LDH, and serum creatinine were normal. Contrast-enhanced computed tomography of the abdomen and pelvis showed a right-sided RI. The patient was admitted to the hospital and anticoagulated. Laboratory values remained normal, and a comprehensive workup failed to reveal an etiology for his RI. RI is rare, and affected patients often present with symptoms similar to more common conditions such as lumbago or nephrolithiasis. Elevated LDH may be a clue to the diagnosis, but unlike 92% of the reviewed cases, our patient presented with a normal value. This case suggests that clinicians should consider RI in patients with persistent symptoms for whom more common causes of flank pain have been excluded; including in nonsmoking patients without apparent risk factors for infarction who present with a normal LDH and no leukocytosis.
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PMID:Idiopathic renal infarction in a previously healthy active duty soldier. 2449 28

Renal infarction is an uncommon and underdiagnosed cause of acute flank pain. We describe a 48-year-old male patient, previously diagnosed with a bicuspid aortic valve, who presented with multiple renal infarctions, secondary to multiple dissections of the aberrant renal vascular anatomy.
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PMID:Renal infarctions caused by dissections of surnumerary renal arteries. 2478 75


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