PMC4809340_01
Renal computed tomography.. Notes: (A) Enhanced abdominal computed tomography scan shows rupture of the left kidney with perirenal hematoma (green arrow). The point of rupture is clearly seen (red arrow). (B) Sagittal reconstruction of the computed angiotomography scan showing normal left renal artery with avascular upper pole of left kidney corresponding to the area of rupture (blue arrow).
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Renal ultrasound showed normal-sized kidneys without evidence of hydronephrosis, but it allowed us to identify a subcapsular renal hematoma that measured 63x52 mm in the upper pole of the left kidney, which was confirmed by abdominal computed tomography (CT) scan (Figure 1A). Multislice computed angiotomography scanning identified the hematoma and ruled out microaneurysms of the main renal arteries, other vascular abnormalities, and renal tumors (Figure 1B).
Renal biopsy specimen.. Notes: (A, B and D) Membrano proliferative glomerulonephritis with intracapillary microthrombi. (A) Trichrome stain; original magnification, x400. (B) Eosin and hematoxylin stain; original magnification, x400. (D) Jones silver methenamine stain; original magnification, x600. (C) Extensive necrotizing arteritis affecting an interlobular artery. Eosin and hematoxylin stain, magnification x400.
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Renal biopsy was performed, during surgery, the third day after admission and was submitted for light microscopic and immunofluorescence examination (Figure 2).