PP 108. Isolated Renal Arterial Thrombosis Due to Blunt Thoracoabdominal Trauma: Case Report

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Z. Kilbas, A Harlak, E. Samadov, A Kagan Coskun, O. Mentes, R. Senocak, A Dadasov, O. Kozak

16:48 - 16:54h at Margrit Room

Categories: Emergency Surgery, Poster Session

Session: Poster II (P3) - Emergency / Thoracic Surgery

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Background
Isolated renal arterial thrombosis induced by blunt abdominal trauma occurs substantially rare. Classical approach in cases of renal arterial injury usually requires nephrectomy, however renal sparing theraphy should be prioritised in current approach. Optimal treatment for this uncommon entity has not yet been established. In this study, application of selective renal arterial stenting in isolated renal arterial thrombosis is presented.

Material and Methods
We present a case and review the literature

Result
A 21 year-old male patient was observed clinically due to blunt toracoabdominal trauma (because of being crushed under a truck ) following first intervention in the ward. Because of pneumothorax that had occured shortly after trauma, bilateral tube thoracostomy was applied. In his physical examination bilateral eyes were echimotic and oedematos. Thrombosis of left renal arteria was suspected thorugh thoracoabdominal tomography scan and the other intraabdominal structures were normal. A CT angiography investigation showed that occlusion a 2 cm lenght in a segment within the middle of left renal artery. Thereby an expandable ballon stent was placed into the segment where thrombosis occured. After the prosedure, renal arterial flow was assesed as patent by enhanced contrast angiogram.

Conclusion
In case of isolated renal arterial thrombosis, treatment options include observation, conservative approach, thrombolytic medications, surgically nephrectomy and recently percutaneous transluminal angioplasty and stent placement. In selected patients, stent placement into the renal artery can reduce the renal damage and clear away the necessity of nephrectomy. It must be diagnosed and treated as soon as possible to avoid progressive permanent loss of renal function.