Renal Artery Dissection in an Emergency Department Patient With a Near Fall

Abstract

51-year-old male presented to the emergency department with left flank pain after a near fall on steps. Computed tomography of the abdomen and pelvis with contrast showed a non-enhancing left kidney, secondary to suspected acute traumatic dissection of the left renal artery.Renal artery dissection is typically affiliated with blunt abdominal trauma, though it can also occur spontaneously. The diagnosis of a renal artery dissection after minor trauma can often go unrecognized due to a lack of initial severe symptoms. Management will vary upon the age of the injury, the preservation of the kidney, and the extent of associated injuries. Ultimately, management should be dictated by discussion with trauma surgery, vascular surgery, urology, or interventional radiology consultants. Knowing the mechanism of injury and patient risk factors can help guide your ability to successfully identify and treat the patient, limiting delays in care and potentially lowering the incidence of organ injury.