ABSTRACT
A 57-year-old woman with an extensive cardiac history presented complaining of left flank pain. An intravenous pyelogram performed for the presumptive diagnosis of renal calculus showed poor function of the left kidney. Angiography demonstrated a 95% obstructing embolus in the left renal artery, which was removed surgically. This case illustrates some of the pitfalls in the diagnosis of renal artery obstruction and the need for a high index of suspicion. The intrarenal infusion of thrombolytic agents such as streptokinase may become the treatment of choice despite the success of surgical embolectomy. The diagnosis, laboratory analysis, and treatment of renal artery obstruction is discussed.
Subject(s)
Renal Artery Obstruction/diagnosis , Adult , Angiography , Female , Heart Diseases/complications , Humans , Renal Artery Obstruction/etiology , Renal Artery Obstruction/physiopathology , Renal Artery Obstruction/surgery , Thromboembolism/complications , UrographySubject(s)
Meat , Trichinellosis/etiology , Adult , Animals , Humans , Male , New Jersey , Swine/parasitologyABSTRACT
Spontaneous spinal epidural hemorrhage is a rare emergency. It is characterized by back pain with radicular radiation in the chest and extremities followed by progressive signs of cord compression. The exact etiology is unknown. Presented here is the case of a 34-year-old man who arrived in the emergency department with back pain, followed 20 minutes later by acute paralysis of both legs. Emergency laminectomy revealed an epidural hematoma with compression of the spinal cord. The man was discharged from the hospital seven days post-evacuation of the hematoma with a slightly unsteady but improving gait. The presenting symptoms, etiology, pathophysiology, differential diagnosis, and treatment of this unusual lesion are reviewed.
