PMC5292180_01
Ultrasonography of the abdomen with convex probe shows at the level of the middle-upper pole of the right kidney a wedge-shaped hypoechoic area, which appears clearly demarcated (arrows).
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The US study was completed with a convex probe (5-7 MHz) to exclude other possible causes of abdominal pain and it showed, at the level of the middle-upper pole of the right kidney, a wedge-shaped hypoechoic area (Figure 1), which did not show any vascular signal at color and power-Doppler study, unlike the adjacent parenchyma.
Ultrasonography of the abdomen with convex probe, transverse scan, color-Doppler study: at the level of the right kidney, there is lack of flow involving the median branch of a triple renal artery (arrow).
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In addition, there was a triple renal artery with lack of perfusion of the median branch (Figure 2).
Contrast-enhanced CT scan, axial image, portal phase shows a cuneiform hypodense and nonenhancing area of 5 cm in diameter at the middle-upper pole of the right kidney (arrows).
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A contrast-enhanced computed tomography (CT) was performed and showed a cuneiform low attenuation area of 5 cm in diameter at the middle-upper pole of the kidney (Figure 3). This abnormality was likely related to the described hypovascular area of the renal parenchyma, with normal enhancement in the medium-caudal portion of the kidney (Figure 3).
Contrast-enhanced CT scan, axial image, arterial phase shows intraluminal subtotal filling defect due to a thrombosis of a branch of the triple renal artery (arrows) from the origin up to its most peripheral ramifications.
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Moreover, there was a triple right renal artery, with an incomplete filling defect due to a thrombosis involving the median artery from the origin up to its most peripheral ramifications (Figure 4).