Korean J Nephrol.  2009 May;28(3):270-274.

A Case of Acute Bilateral Renal Cortical Necrosis Associated with Peritonitis and Intra-abdominal Operation

• Kang GW
• Park KK
• Lee IH

Abstract

Renal cortical necrosis (RCN) is a rare cause of acute renal failure in which there is a complete or partial destruction of the renal cortex with sparing of the medulla. We report here a case of acute bilateral RCN associated with intra-abdominal operation. A 70-year-old female patient was admitted to our hospital because of abdominal pain secondary to perforated diverticulits in sigmoid colon. A segmental resection of the sigmoid colon and end-to-end anastomosis was performed on the third hospital day. Two days later, she suddenly developed oligo-anuria and she was treated with hemodialysis. A contrast-enhanced abdominal computed tomography scan showed lack of enhancement of the renal cortex with enhancement of the renal medulla. On the 21th hospital day, renal biopsy was done and microscopic examination of the specimen revealed RCN. Since then, she has been on regular hemodialysis for over six months with no signs of renal recovery. Occult sepsis associated with peritonitis and intra-abdominal operation seems to be the most possible etiologic factor of RCN in our patient.

Keyword

Renal cortical necrosis; Kidney failure; Acute

MeSH Terms

Abdominal Pain
Acute Kidney Injury
Aged
Biopsy
Colon, Sigmoid
Female
Humans
Kidney Cortex Necrosis
Peritonitis
Renal Dialysis
Renal Insufficiency
Sepsis