Embolic Segmental Renal Infarction in a Patient with Atrial Fibrillation

IntroductionRenal infarct is rare and often misdiagnosed because the symptoms are misleading. The mechanisms are various, mainly thrombotic and embolic.Case presentationIn this review, we report the case of a 61-year-old Tunisian woman presented to the emergency unit with a 4-hour history of abdominal pain diffused at both flanks, ultrasounds was performed to remove a surgical emergency, showed a peri-renal fluid collection with heterogeneous parenchyma.We followed by a CT scan, which confirmed the diagnosis of renal infarct. The patient was treated by heparin at a curative dose, and the outcome was favorable.ConclusionDiagnosis is difficult and should be considered in patients with inexplicable flank or abdominal pain and with risk factors to this disease. Our purpose is to raise clinician’s awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment.A review of the literature was performed and the case is discussed in the context of the current knowledge of this condition.

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Bilateral renal infarction following atrial fibrillation and thromboembolism and presenting as acute abdominal pain: a case report

Bouassida

Hmida

Zaïri

et al. 2012

J Med Case Reports

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Epigastric Pain in Acute Renal Infarction: The Forgotten Presentation

Maadarani¹,

Bitar²

2015

European Journal of Case Reports in Internal Medicine

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Epigastric pain is a manifestation of several medical and surgical conditions. However, when persistent epigastric pain is associated with microscopic or frank haematuria and elevated lactate dehydrogenase (LDH), especially in patients with increased risk of thromboembolic events, acute renal infarction (ARI) should be considered. We report the case of a 77-year-old male patient who presented with sudden persistent epigastric pain and elevated LDH who was found to have atrial fibrillation. The patient was diagnosed with ARI. ARI is not usually a typical differential diagnosis in patients with persistent epigastric pain and elevated LDH in whom the risk of thromboembolic events is high. Thus, physicians should perform a contrast-enhanced CT scan as early as possible to rule out or confirm renal infarction. LEARNING POINTS • In acute kidney infarction, epigastric pain can be one of the clinical manifestations. • The combination of unexplained epigastric pain and elevated lactate dehydrogenase and haematuria in a patient with an increased risk of thromboembolic events should raise the suspicion of acute kidney infarction. • The physician should perform a contrast-enhanced CT scan as early as possible to rule out or confirm kidney infarction.

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Embolic Segmental Renal Infarction in a Patient with Atrial Fibrillation

Cited by 2 publications

References 3 publications

Bilateral renal infarction following atrial fibrillation and thromboembolism and presenting as acute abdominal pain: a case report

Bilateral renal infarction following atrial fibrillation and thromboembolism and presenting as acute abdominal pain: a case report

Epigastric Pain in Acute Renal Infarction: The Forgotten Presentation

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