Post-traumatic renal artery thrombosis secondary to blunt abdominal trauma: a rare case report
- Harry Galuh Nugraha ,
- Eppy Buchori Aristiady ,
- Hilman Hilman ,
- Dian Komala Dewi ,
- Leni Santiana ,
- Puspita Arum ,
Background: Blunt abdominal trauma is one of the leading causes of morbidity and mortality among populations worldwide. However, renal artery injury due to blunt abdominal trauma is a rare occurrence. In this case, a patient who suffered multiple trauma was found in the emergency department, including blunt abdominal trauma, after a motor vehicle accident.
Case report: A 13-year-old boy with multiple trauma was referred to our emergency department, with the primary consideration being to lose consciousness 3 hours before admission due to a traffic accident. After receiving examination, there was no evidence of abdominal bruising, whereas the results of the head CT scan show epidural hemorrhage. After four days of treatment, the urea and creatinine serum levels increased, abdominal CT scan shows right renal infarction suggestive of right renal arterial rupture. The patient was diagnosed with a moderate head injury and right renal trauma AAST grade IV. The patient was referred to the interventional radiology unit. The endovascular revascularization techniques were performed with renal artery stent placement and vasodilator (nitroglycerin) flush into the renal artery before stent placement. Renal artery stenting placement performed on main right renal artery demonstrates the absence of intraluminal defects and substantially blood flow was established, abdomen CT Scan shows an enhancement on right renal parenchyma which mean right kidney vascularization appears to be improved with the return of glomerular filtration rate to normal value at the time the patient was discharged.
Conclusion: Traumatic renal artery thrombosis is a rare occurrence with devastating consequences if any imaging is missed. Endovascular therapy plays a significant role in the treatment of renal artery thrombosis with a better prognosis.