Radiologic and Laboratory Characteristics of Acute Renal Infarction in the Emergency Department

ABSTRACT

PURPOSE: Renal infarction is one of the uncommon causes of acute abdominal pain, and it is often difficult to make a clinical diagnosis. This study was designed to investigate clinical predictors of the acute renal infarction and to suggest useful diagnostic tools to use in the emergency department(ED). METHODS: We reviewed medical records of the patients with a final diagnosis of acute renal infarction, which was confirmed by contrast-enhanced computed tomography (CT) scan or angiography of the abdomen between Jan. 1998 and Dec. 2000. RESULTS: Among 24 patients with acute nontraumatic renal infarction, 17 patients (71.0%) had a thromboembolic disease. A number of patients presented with nonspecific abdominal pain. 23 patients (95.8%) had elevated serum LDH after 24 hours of presention. On initial urinalysis, 75.0% of patients (18/24) showed hematuria. CONCLUSION: This study suggests that the patients with pain in the flank or the abdomen or the low back area should be performed a contrast-enhanced CT scan as soon as possible to rule out the possibility of acute renal infaction, especially when the patient has the high-risk triad of thromboembolism, elevated serum LDH, and hematuria.