Clinical manifestations Renal Infarction: Flank pain, hematuria, and proteinuria; fever, leukocytosis; nausea, vomiting. Oliguric renal failure may occur. Hypertension develops several days afterward.
Diagnosis Renal Infarction: Determine the cause of the embolism and thrombosis; should be considered in patients with cardiac arrhythmias x Laboratory findings: Elevated GOT (= AST), LDH (very high), and AP. LDH and AP may also be elevated in the urine.
x Sonography with follow-up scans; ultrasound contrast agents may be used if
needed
x CT with contrast medium
x Angiography is rarely necessary
Sonographic findings Renal Infarction:
x The kidney may appear sonographically normal in the acute stage of a renal
artery embolism, or it may contain a wedge-shaped hypoechoic area whose
apex points toward the renal pelvis.
x Later an echogenic triangular scar develops, causing an indentation of the renal
surface with narrowing of the parenchymal border.
x With a hemorrhagic infarction due to renal artery thrombosis, parenchymal
bleeding leads to an irregular, patchy echogenic area in the renal parenchyma.
x CDS shows an absence of flow in the renal artery and may show a wedgeshaped perfusion defect in the parenchyma.
x Later scans show a decrease in renal size.
Accuracy of sonographic diagnosis Renal Infarction: A fresh infarction cannot be confidently diagnosed without CDS, which has an accuracy rate up to 85%. The diagnosis can be established by using ultrasound contrast agents or CT angiography.
ultrasound images Renal Infarctiona, b Renal infarction. a Wedge-shaped, s harply circumscribed hyperechoic area. b Magnification: The triangular avascular area confirms the infarction. The patient presented clinically with flank pain. For CDS see also Figs.
“Ultrasound cases info Renal Infarction”
“Ultrasound upper abdominal pain”