Fact-sheet: Renal infarctus
Updated on 04/19/2018 at 4:42 PM
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Definition
Ischemic lesion of all or part of the renal parenchyma, which may be embolic in origin or secondary to a renal artery lesion (thrombosis, dissection)
Clinical features
Abdominal pain.
Laboratory findings
Microscopic hematuria.
Renal failure in the setting of a solitary kidney.
Ultrasound
Increased echogenicity of the renal cortex.
Absence of vascularization on Doppler.
CT
Wedge-shaped area of absent renal parenchymal enhancement.
Enhancement of the capsule (cortical rim sign, cortex corticis) = subacute phase
Kidney often enlarged.
Absence of contrast material excretion on delayed phase.
Often marked infiltration of the perirenal fat.
Management
Treatment of the underlying cause.
Differential diagnosis
Focus of acute focal pyelonephritis: non-enhancing area(s) with parenchymal swelling; no persistent subcapsular enhancement.
Renal abscess.