An uncommon cause of acute flank pain: renal infarction

  • Giuseppe De MatteisEmail author
  • Federica Cutillo
  • Andrea Contegiacomo
  • Angelo Santoliquido
  • Giovanni Gambassi

Renal infarction is a rare condition due to the occlusion of the renal artery by thromboemboli of cardiac origin or by in situ thrombosis. However, the frequency of renal infarction may be higher than detected, because the diagnosis is often missed or delayed because of nonspecific presentation of symptoms. A prompt diagnosis is a challenge, and it is crucial in preserving renal function. Here, we describe a case of cardioembolic renal infarction that, despite being immediately detected and treated, led to impaired renal function due to the prolonged duration of ischemia.

A 29-year-old woman with a history of iatrogenic dilated cardiomyopathy (NYHA I)—secondary to anthracycline therapy performed to treat a leukemia that had occurred in childhood—was admitted to the Emergency Department complaining of acute right flank pain started about 12 h before. She reported an acute onset of pain, immediately after awakening, not improved by painkillers. Vital signs were within normal limits....


Author contributions

All the authors equally contributed to the drafting of this case, literature review, critical revision, editing, and approval of the final version.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights and animal rights 

This case image complies with the ethical standards outlined in the journal. It involved the medical management of a patient as per society guidelines and was in accordance with the ethical standards of the institution. This case was not formal research involving human participants and/or animals.

Informed consent

Informed consent was taken from the patient.


  1. 1.
    Antopolsky M, Simanovsky N, Stalnikowicz R, Salameh S, Hiller N (2012) Renal infarction in the ED: 10-years experience and review of the literature. Am J Emerg Med 30:1055–1060CrossRefPubMedGoogle Scholar
  2. 2.
    Bourgault M, Grimbert P, Verret C, Pourrat J, Herody M, Halimi JM, Karras A, Amoura Z, Jourde-Chiche N, Izzedine H, François H, Boffa JJ, Hummel A, Bernadet-Monrozies P, Fouque D, Canouï-Poitrine F, Lang P, Daugas E, Audard V (2013) Acute renal infarction: a case series. Clin J Am Soc Nephrol 8:392–398CrossRefGoogle Scholar
  3. 3.
    Hazanov N, Somin M, Attali M, Beilinson N, Thaler M, Mouallem M, Maor Y, Zaks N, Malnick S (2004) Acute renal embolism. Forty-four cases of renal infarction in patients with atrial fibrillation. Medicine (Baltimore) 83:292–299CrossRefGoogle Scholar
  4. 4.
    Can MM, Tanbog IH et al (2010) Acute kidney infarction secondary to intracardiac thrombus embolization in a patient with ischemic dilated cardiomyopathy. Cardiology 117:219–221CrossRefPubMedGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna (SIMI) 2018

Authors and Affiliations

  • Giuseppe De Matteis
    • 1
    Email author
  • Federica Cutillo
    • 1
  • Andrea Contegiacomo
    • 2
  • Angelo Santoliquido
    • 1
  • Giovanni Gambassi
    • 1
  1. 1.Department of Internal and Emergency Medicine, Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University of the Sacred Heart School of MedicineRomeItaly
  2. 2.Department of Bioimaging and Radiological Sciences, Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University of the Sacred Heart School of MedicineRomeItaly

Personalised recommendations