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논문분류	춘계학술대회 초록집
제목	A case of renal infarction that recurred after transient resolution in short period proven by computed tomography
저자	In Hong Choi
출판정보	2023; 2023(1):
키워드
초록	Although renal infarction (RI) is not a rare disease, the outcome of RI has not been well reported. Furthermore, the transient resolution and recurrence of RI have not been demonstrated by imaging. We report a case of idiopathic RI that recurred within short period after transient resolution demonstrated by serial computed tomography (CT). A 53-year-old man diagnosed of RI was transferred to emergency room (ER). The abdomen CT at the local hospital showed a segmental wedge-shaped perfusion defect in left kidney and a focal thrombotic filling defect in anterior segmental branch of left renal artery. He complained of left flank pain at first, but gradually improved. Vital signs were stable. Laboratory studies showed that leukocytosis with WBC count of 12.9x/μL, and elevated lactate dehydrogenase of 640IU/L. There was no renal impairment, hematuria or pyuria. In abdomen CT performed at ER, the thrombus in anterior segmental branch of left renal artery was remained, but the perfusion defect in left kidney was spontaneously resolved. Cardiac disorder, hypercoagulability and vasculitis, which could be the cause of RI, were not found. We finally diagnosed idiopathic RI and initiated anticoagulation with unfractionated heparin. On the sixth day of hospitalization, left flank pain recurred, so an abdomen CT was performed again. In the re-performed CT, RI recurred in the same area as before. We continued anticoagulation and switched to warfarin. After treatment, the patient’s symptom was improved, he was discharged on the eighth day of hospitalization with anticoagulation maintained. RI could recur at any time even after spontaneously resolved as in our case. Therefore, it is necessary to closely monitor whether symptoms recur in the patients who resolved RI and radiologic evaluation should be performed even within a short period.
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