What does a renal infarct look like?

Renal infarcts are most easily identified on post contrast images, preferably in the cortical/arterial phase. One or more focal, wedge-shaped parenchymal defects that involve both the cortex and medulla and extend to the capsular surface are demonstrated 1.

What is the typical shape of an infarct within the kidney?

Contrast-Enhanced Renal Ultrasound In such situations, CEUS can demonstrate absence of enhancement of the affected renal tissue (Fig. 34.4). Acute infarcts typically are seen as wedge-shaped, nonenhancing areas within an otherwise normal-appearing kidney. Renal shape is preserved.

Why is a wedge infarct in the kidney?

Comment: Renal infarcts usually appear as well-demarcated, wedge-shaped or triangular areas of coagulative necrosis that extend from the capsular surface into the medulla. The characteristic shape results from the kidney’s unique vascular supply.

Which artery in the kidney likely caused the infarct?

The two major causes of renal infarction are thromboemboli and in situ thrombosis. Thromboemboli usually originate from a thrombus in the heart or aorta, and in situ thrombosis is usually due to an underlying hypercoagulable condition or injury to or dissection of a renal artery.

What is acute pyelonephritis?

Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness.

How is renal infarct diagnosed?

Acute renal infarction is a rare cause of acute abdominal pain. It has to be expected in the patients with cardiovascular risk factors. Most accurate diagnostic tool is the helical CT scan of abdomen. Once it is diagnosed, preferred therapies are percutaneous endovascular therapy, anticoagulation, or thrombolysis.

What are the classic signs of pyelonephritis?

The classic presentation in acute pyelonephritis is the triad of fever, costovertebral angle pain, and nausea and/or vomiting. These may not all be present, however, or they may not occur together temporally. Symptoms may be minimal to severe and usually develop over hours or over the course of a day.

What are the key features of acute pyelonephritis?

Symptoms usually include fever, flank pain, nausea, vomiting, burning on urination, increased frequency, and urgency. The 2 most common symptoms are usually fever and flank pain. Acute pyelonephritis can be divided into uncomplicated and complicated.

What is right renal infarct?

Renal infarction results from interruption of the normal blood supply to part of, or to the whole kidney. The main imaging differential diagnosis includes pyelonephritis and renal tumors.

What are the symptoms of RVT?

Acute renal vein thrombosis usually presents with symptoms of renal infarction, including flank pain, flank tenderness, rapid deterioration of renal function and worsening proteinuria, micro or macroscopic hematuria. Nausea, vomiting or fever may be present.

What is the role of CT in the evaluation of pyelonephritis?

Computed tomography (CT), when performed before, immediately after, and at delayed intervals from contrast material injection, is the preferred modality for evaluating acute bacterial pyelonephritis. CT is also preferred over conventional radiography and ultrasonography (US) for assessing emphysematous pyelonephritis.

What are the symptoms of acute pyelonephritis?

Furthermore, acute pyelonephritis may cause gastrointestinal symptoms, such as abdominal pain, nausea, vomiting, and diarrhea, which confound the diagnosis (,5). Laboratory findings include pyuria, granular or leukocytic casts, bacteriuria, and a positive urine culture.

How is pyelonephritis diagnosed with an ultrasound?

Ultrasound. Ultrasound is insensitive to the changes of acute pyelonephritis, with most patients having ‘normal’ scans. Abnormalities are identified in only ~25% of cases 1. Possible features include: particulate matter/debris in the collecting system. reduced areas of cortical vascularity by using power Doppler.

What is pyelonephritis (kidney infection)?

Acute pyelonephritis (plural: acute pyelonephritides) is a bacterial infection of the renal pelvis and parenchyma most commonly seen in young women. It remains common and continues to have significant morbidity in certain groups of patients.