Renal artery thrombosis following blunt trauma.

Renal artery thrombosis after blunt trauma presented without other injury, without external signs of trauma, and without hematuria in the case reported. Review of 65 cases from the literature showed that flank and epigastric pain and proteinuria are usually present. Renal artery thrombosis following blunt trauma has usually been diagnosed too late to salvage the kidney. Nephrectomy is performed for ileus, fever, and pain caused by the necrotic kidney, or for hypertension. Ideally, rapid diagnosis by intravenous pyelogram and arteriography and early surgical intervention should allow revascularization and renal salvage before permanent parenchymal damage has occurred. The cases reviewed showed that successful revascularization without hypertension could be achieved 12 hours after injury. Patent small collateral vessels as well as incomplete or gradual renal artery occlusion may prolong renal salvage time.