Page phenomenon in a transplanted kidney: is it salvageable?

Abstract

A male in his late 70s with a history of an uncomplicated kidney transplantation 20 years prior was brought to the Emergency Department after experiencing blunt abdominal trauma following a motor vehicle collision. Imaging revealed a large perinephric haematoma, a retroperitoneal haematoma and multiple fractures. He was admitted to the intensive care unit where a renal haematoma was found to be expanding with ultrasonography (US) and developed renal dysfunction including anuria and hyperkalemia. His creatinine rose to twice his baseline and Doppler US showed elevated resistive indices, confirming extrinsic compression and causing a Page phenomenon. An open surgical exploration through the upper aspect of his Gibson incisional scar was performed followed by evacuation of the haematoma. An intraoperative US was done demonstrating good flow in the renal vessels. His postoperative course was uncomplicated and was discharged home with renal function back to baseline. On follow-up, he continued to have a good renal function.

A Rare Case of Page Kidney With Superimposed Infection

“…The first PK cases consisted of young male athletes with a history of sports-related trauma who developed hypertension [5]. However, in recent years, kidney transplants and biopsies have emerged as new causes of PK in the literature [6,7]. A retrospective study of 518 transplant biopsies, during seven years from January 2000 to September 2007 at a Multi-Organ Transplant Program, London Health Sciences Centre, University Hospital in Ontario, Canada, found an incidence of post-procedure acute PK of about 1% [8].…”