[Renal colic "ischemic" of renal infarction: A plea for routine helical CT in emergency]

Prog Urol. 2011 Mar;21(3):184-90. doi: 10.1016/j.purol.2010.08.052. Epub 2010 Oct 14.
[Article in French]

Abstract

Objectives: Through a retrospective cohort, to analyse causative factors of acute renal infarction and specific therapeutic. Recall the need to carry a computerised tomoraphy (CT) in any flank pain suggestive of renal colic can hide a renal infarct.

Method: Over a period of 24 months (2008-2009), we have compiled six patients admitted for acute lumbar pain reported in renal colic and showing a renal infarction. We report the risk factors for cardiovascular disease, the clinical presentation, and the interest of heparin therapy started early in the recovery of renal function. We emphasise the need for abdominal-pelvic CT in emergency before a renal colic pain associated with injection of contrast medium if no stone obstacle is identified.

Results: Five patients had risk factors for cardiovascular disease including one personal history of deep vein thrombosis and pulmonary embolism and two, a family history of myocardial infarction. Five patients were treated early with LMWH, and for one the herapin was started at 72 hours of onset of symptoms. In all cases, no effect on renal function was noted.

Conclusion: Renal infarction is a rare but probably underestimated, occurring on land known cardiovascular often. The abdominopelvic CT without injection is increasingly practiced in front of abdominal pain syndromes, it seems imperative to complete the review by the injection of contrast material if stone obstruction is unconfirmed. Early management by herapin appears to improve the complete recovery of renal function.

MeSH terms

  • Adult
  • Emergencies
  • Female
  • Humans
  • Infarction / complications*
  • Infarction / diagnostic imaging*
  • Ischemia / complications*
  • Ischemia / diagnostic imaging*
  • Kidney / blood supply*
  • Male
  • Middle Aged
  • Renal Colic / diagnostic imaging*
  • Renal Colic / etiology*
  • Retrospective Studies
  • Tomography, Spiral Computed*