Acute Renal Infarction in a Patient Presenting With Abdominal Pain and Hypertensive Emergency.

Acute renal infarction is a rare but clinically important cause of abdominal pain and is frequently overlooked due to its nonspecific presentation. We report the case of a 46-year-old man who presented with progressive periumbilical abdominal pain and hypertensive emergency. Initial laboratory evaluation was nondiagnostic. Contrast-enhanced computed tomography demonstrated a wedge-shaped perfusion defect in the right kidney with segmental renal artery thrombosis, confirming acute renal infarction. Because his symptoms had been present for more than 72 hours, endovascular intervention was not pursued, and the patient was managed conservatively with systemic anticoagulation and aggressive blood pressure control. This case highlights the diagnostic challenges associated with renal infarction and emphasizes the importance of early imaging in patients presenting with abdominal pain and severe hypertension.