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Korean J Nephrol. 2002 May;21(3):499-502. Korean. Case Report.
Park SH , Choi HJ , Jang MH , Cho JH , Shin YB , Lee DH , Kim YL , Cho DK , Huh S , Kim YW , Kim YJ .
Department of Internal Medicine, College of Medicine, Kyungpook University, Daegu, Korea.
Department of Genernal Surgery, College of Medicine, Kyungpook University, Daegu, Korea.
Department of Diagnostic Radiology, College of Medicine, Kyungpook University, Daegu, Korea.

It is usually known that arterial dissection is associated with malignant hypertension, severe atherosclerosis or trauma. Marfan syndrome or Ehlers- Danlos syndrome may also be rare causes. However, as in this case, spontaneous arterial dissection without aortic dissection in normotensive men is rarely reported. A 39-year-old man presented with acute onset right flank pain with microscopic hematuria. Physical examination was unremarkable and his blood pressure was normal. Clinical impression was urolithiasis because he experienced two episodes of urolithiasis previously. IVP was not completed due to adverse reaction during study. Right renal infarction was diagnosed by contrast-enhanced computed tomography. To search for possible cardiac embolic disease, the patient underwent surface echocardiography, which was normal and a detailed evaluation for a thrombotic tendency was unremarkable. A renal arteriogram showed dissection of the main right renal artery with extension to renal artery branches and a wedge-shape perfusion defect in the distal part of the occluded artery. He received aorto-renal bypass surgery using his great saphenous vein. The patient developed hypertension 3 months later. To summary, we report a case of spontaneous renal artery dissection with renal infarction in a healthy man without hypertension.

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