ABSTRACT
OBJECTIVE: To describe a useful algorithm when acute non-traumatic renal artery occlusion is suspected. METHODS: The diagnostic and therapeutic aspects of this uncommon disease are analyzed through two cases that had been managed differently. RESULTS: Early clinical suspicion is based upon a non-colic sudden flank pain in patients with a history of cardiac embolic events, increased serum LDH, ALAT and ASAT, proteinuria, non-lithiasic, non-functioning kidney on IVP and a normal sized non-dilated kidney on ultrasound. The next step is diagnostic angiography and fibrinolysis when indicated. CONCLUSIONS: Intra-arterial fibrinolysis is the treatment of choice in renal artery embolism when functional recovery by angiographic and clinical criteria is present, and will be further enhanced the earlier the diagnosis is made.
Subject(s)
Embolism , Renal Artery , Aged , Algorithms , Embolism/diagnosis , Embolism/epidemiology , Embolism/etiology , Embolism/physiopathology , Embolism/therapy , Female , Humans , Male , Middle AgedABSTRACT
Necrosing vasculitis and, within it, nodosa polyarteritis, is an infrequent entity characterized by the absence of pathognomonic signs and symptoms, but which can potentially affect the entire body. The initial description was made by Kussmaul and Maier in 1866. Sings and symptoms of this clinical picture are not frequently circumscribed to the urinary tract. We describe here one case of a particularly infrequent presentation, as a vesical mass with gross haematuria. The paper discusses the clinical picture, diagnosis and treatment of this process.
