Clinical Progression of Segmental Arterial Mediolysis; Renal Infarction and Intra-abdominal Hemorrhage.
- Author:
Jae Hyung CHOI
1
;
Young Soon CHO
;
Jae Woo KIM
;
Jung Won LEE
;
Hyung Jun MOON
Author Information
1. Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Bucheon, Korea. emer0717@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Renal artery obstruction;
Hemoperitoneum;
Angiography
- MeSH:
Abdominal Pain;
Angiography;
Emergencies;
Flank Pain;
Hemoperitoneum;
Hemorrhage;
Humans;
Infarction;
Kidney;
Male;
Perfusion;
Renal Artery Obstruction;
Splenic Artery;
Syncope;
Vascular Diseases
- From:Journal of the Korean Society of Emergency Medicine
2012;23(6):907-911
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This article reports a patient with both a renal infarction and acute intra-abdominal hemorrhage secondary to a rare vascular disease, segmental arterial mediolysis. The patient was a 37-year-old male who presented with acute right flank pain. Abdominal and pelvic computerized tomography (CT) showed a right renal infarction. After three days, the right flank pain had diminished but left flank pain began. Visceral angiography revealed a wedge shape perfusion defect at the mid pole of the left kidney, suggesting a left renal infarction but there were no definite perfusion defects at the right kidney. After ten days, the patient complained of abdominal pain and 2 episodes of syncope. Abdominal CT revealed active bleeding from the splenic artery and a large amount of hemoperitoneum. After emergency embolization, the patient's were stabilized. After 28 days, his condition was improved and discharged without complications. The angiographic and laboratory findings were consistent with a diagnosis of segmental arterial mediolysis involving the renal and splenic artery. This is the first case report of clinical progression related to segmental arterial mediolysis requiring emergent coil embolization.
