1/12. Unilateral acute renal cortical necrosis: correlative imaging.Bilateral acute cortical necrosis is a rare form of acute renal failure characterized by necrosis of the renal cortex and sparing of the medulla. Little information on the imaging presentation of bilateral acute renal cortical necrosis is available. The enhanced CT appearance is pathognomonic and diagnostic. The unilateral presentation of acute cortical necrosis is extremely rare, and no imaging methods have been described. The authors chose to apply scintigraphic evaluation to this unique condition complementary to CT to confirm the diagnosis. Mercaptoacetylglycine (T3) was selected to assess tubular damage, in contrast to the pure glomerular agent DTPA. Evidence of some tubular function and clear delineation of the shrunken kidney was found. Conversely, in the DTPA study the kidney was not visualized. A DMSA scan was performed for assessment of viability of the renal cortex and showed a photopenic halo around the small area of the viable cortex of the upper pole. The halo sign represents a cortical loss. The visualization of the upper pole as evidence of cortical viability as a consequence of collateral blood flow from capsular vessels was seen on angiography. Radiographic and scintigraphic correlation of this rare condition may be an effective means to confirm the diagnosis and to establish the extent of involvement. However, contrast CT remains the preferred method in the diagnosis of acute cortical necrosis.- - - - - - - - - - ranking = 1keywords = kidney (Clic here for more details about this article) |
2/12. MR imaging features of acute bilateral renal cortical necrosis.Bilateral renal cortical necrosis (BRCN) is an uncommon cause of acute renal failure. Kidney biopsy, arteriography, and contrast-enhanced computed tomography (CT) are usually used to diagnose BRCN. However, these methods can have potentially serious side effects. We report two cases in which magnetic resonance imaging (MRI) evidenced characteristic features of BRCN, which were confirmed by histological findings and arteriography and correlated with clinical evolution. In the first case report, the diagnosis of a massive and complete cortical necrosis variety was suggested on MRI that showed a thin rim of low signal intensity along border of kidneys. It was confirmed on kidney biopsy, and the renal function did not recover. The second case is an incomplete form with cortical patchy areas of low signal intensity. In these two patients, MRI helped to establish an early diagnosis of BRCN with characteristic representative findings, without the potential nephrotoxic effects of iodinated contrast that has to be used in CT and arteriography. Kidney biopsy, besides the risks of complications, provides only a parceled analysis of the renal tissue and therefore does not allow any conclusion as to the extension of cortical necrosis. MRI may be of great help for the diagnosis and follow-up of acute renal cortical necrosis.- - - - - - - - - - ranking = 1keywords = kidney (Clic here for more details about this article) |
3/12. Bilateral renal cortical necrosis: a report of 2 cases.Two cases of renal cortical necrosis, one of which occurred after an obstetric complication (abruptio placentae) and the other after postpartum haemorrhage, are described. The diagnosis was made by percutaneous renal biopsy, intravenous pyelography and selective nephro-angiography. Immunofluorescence studies of the kidney showed no abnormality in one patient, but showed the presence of IgM in the glomerular basement membrane in the second patient. hypotension was not observed when anuria occurred. Both patients survived. The importance of prolonged haemodialysis is stressed, since one patient was oliguric for 57 days and required intermittent haemodialysis for 5 months, while the second patient was oliguric for 17 days, required haemodialysis for 5 months and now has established hypertension.- - - - - - - - - - ranking = 0.5keywords = kidney (Clic here for more details about this article) |
4/12. Acute bilateral renal cortical necrosis as a cause of postoperative renal failure.Acute renal failure after a major intra-abdominal operation is, unfortunately, not an infrequent occurrence. Acute tubular necrosis, the most common cause of postoperative renal failure, usually follows a predictable clinical course, with most patients recovering full renal function. We describe a patient who developed acute renal failure after orthotopic liver transplantation. Subsequent workup revealed the patient to have acute bilateral renal cortical necrosis. Bilateral renal cortical necrosis is an extremely rare cause of renal failure and an even rarer cause of postoperative renal failure. We discuss the diagnosis and management of this uncommon disorder and review the salient literature. Of the approximately 15 known reported cases involving native kidneys after a major nonobstetric abdominal operation in the world literature, we believe this is the first to be related to an orthotopic organ transplant.- - - - - - - - - - ranking = 0.5keywords = kidney (Clic here for more details about this article) |
5/12. renal artery dissection after blunt abdominal trauma: a rare cause of acute cortical necrosis.renal artery injury is an uncommon complication of blunt abdominal trauma. We present a case of a 19-year-old man who developed acute cortical necrosis in a congenital single kidney after a motorcycle accident. On initial presentation, he had signs of splenic injury and required immediate laparotomy and splenectomy. His renal function deteriorated, and he became dialysis dependent. Computed tomography followed by percutaneous angiography showed a dissection of a single renal artery causing the formation of a large pseudoaneurysm. A second angiogram showed an increase in the size of the pseudoaneurysm. We performed a laparotomy and attempted in situ vein graft repair of the renal artery. A wedge biopsy specimen taken at laparotomy revealed acute cortical necrosis, and plain radiographs showed cortical calcification. renal artery dissection and pseudoaneurysm formation are rare events after blunt trauma. Iatrogenic damage is the most common cause of pseudoaneurysm. Traumatic pseudoaneurysms have a poor prognosis without prompt surgical intervention. Renal arterial damage may occur after blunt trauma, and early imaging and intervention are essential to salvage renal function.- - - - - - - - - - ranking = 0.5keywords = kidney (Clic here for more details about this article) |
6/12. Angiographic and ultrasonographic appearance of renal cortical and medullary necrosis in the newborn.Renal cortical and medullary infarction are 2 of the severe complications of perinatal asphyxia and shock. The angiographic and ultrasonographic findings in these conditions have not been described previously. They demonstrate nephromegaly, a nonhomogeneous nephrogram, and internal echoes. Similar findings may be seen in renal vein thrombosis, hydronephrosis, and polycystic kidneys.- - - - - - - - - - ranking = 0.5keywords = kidney (Clic here for more details about this article) |
7/12. MR imaging of acute renal cortical necrosis. A case report.MR imaging of a patient with acute renal cortical necrosis secondary to massive bleeding following an abortion is presented. The kidneys were enlarged with a high signal intensity observed in the renal cortex on both T1- and T2-weighted images. Follow-up MR imaging showed thinned renal cortex of low signal intensity on both pulse sequences representing renal cortical calcification which was confirmed on conventional radiography and CT.- - - - - - - - - - ranking = 0.5keywords = kidney (Clic here for more details about this article) |
8/12. Kidney retrieval from cadaver donors with disseminated intravascular coagulopathy.cadaver kidneys from donors with DIC appear to have an increased incidence of delayed function and primary nonfunction. These kidneys may be safely transplanted if cortical necrosis is ruled out. heparin, antiplatelet therapy, and withholding of cyclosporin A therapy in the early post-transplantation period may improve renal function if there is evidence of glomerular capillary thrombosis.- - - - - - - - - - ranking = 1keywords = kidney (Clic here for more details about this article) |
9/12. Bilateral cortical necrosis and calcification of the kidneys following snakebite: a case report.A 16 year-old-boy was admitted to the ICU of university hospital with acute renal failure following snakebite. The clinical evolution of the patient associated with radiological findings of renal calcification suggested bilateral cortical necrosis of the kidneys. The biopsy findings were compatible with this diagnosis. The patient was discharged 86 days after his admission, with chronic renal failure, since a kidney transplantation was not possible.- - - - - - - - - - ranking = 3keywords = kidney (Clic here for more details about this article) |
10/12. Acute diffuse interstitial fibrosing pneumonitis and bilateral renal cortical necrosis.An autopsy case of a 69-year-old male with acute diffuse interstitial fibrosing pneumonitis complicated by bilateral renal cortical necrosis was presented. autopsy revealed acute diffuse interstitial fibrosing pneumonitis, bilateral renal cortical necrosis, non-bacterial thrombotic endocarditis, involving the aortic and mitral valves, and some interesting vascular lesions, dissemination of fibrinoid change of arterioles and fibrin thrombus of small vessels in various organs; accumulation of polymorphonuclear leukocytes in the lumen of the smaller interlobular arteries and arterioles of the kidney with cellular infiltration and disintegration of the wall; severe disorganization of the wall with intraluminar and intramural fibrinous exudation in smaller branches of the hepatic artery; diminution and disarrangment of muscle fibers and patchy hyalinization in the media of the renal and interlobar arteries. The inter-relationship between acute diffuse interstitial fibrosing pneumonitis, bilateral renal cortical necrosis which may be regarded as a 'hallmark' of the generalized Shwartzman reaction, and disseminated intravascular coagulation was discussed.- - - - - - - - - - ranking = 0.5keywords = kidney (Clic here for more details about this article) |
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