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Journal of The Korean Society of Emergency Medicine 2012;23(6): 907-911. |
| Clinical Progression of Segmental Arterial Mediolysis; Renal Infarction and Intra-abdominal Hemorrhage |
| Jae Hyung Choi, Young Soon Cho, Jae Woo Kim, Jung Won Lee, Hyung Jun Moon |
| Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Bucheon, Korea. emer0717@schmc.ac.kr |
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| ABSTRACT |
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This article reports a patient with both a renal infarction and acute intra-abdominal hemorrhage secondary to a rare vascular disease, segmental arterial mediolysis. The patient was a 37-year-old male who presented with acute right flank pain. Abdominal and pelvic computerized tomography (CT) showed a right renal infarction. After three days, the right flank pain had diminished but left flank pain began.
Visceral angiography revealed a wedge shape perfusion defect at the mid pole of the left kidney, suggesting a left renal infarction but there were no definite perfusion defects at the right kidney. After ten days, the patient complained of abdominal pain and 2 episodes of syncope. Abdominal CT revealed active bleeding from the splenic artery and a large amount of hemoperitoneum. After emergency embolization, the patient's were stabilized. After 28 days, his condition was improved and discharged without complications. The angiographic and laboratory findings were consistent with a diagnosis of segmental arterial mediolysis involving the renal and splenic artery. This is the first case report of clinical progression related to segmental arterial mediolysis requiring emergent coil embolization. |
| Key words:
Renal artery obstruction, Hemoperitoneum, Angiography |
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