F96C6E51-FD2B-4B24-874F-7825CB09B34E

medcases00
Published on Jul 8, 2021
65 year old male with no past medical history came with left flank pain. No fever or dysuria. Urine shows no protein or blood . Has normal
Creatinine . What is the diagnosis?

1) Pyelonephritis
2) Kidney stone
3) emboli renal infarct
4) left main renal artery occlusion

Answer scroll below

Answer is 3 - embolus renal infarct
No signs of UTI or infection. Also main renal artery will cause much more severe ischemia with hematuria and bigger diffuse infarct . Wedge shaped infarct is suggestive of subsegmental renal artery occlusion from emboli event . Stone is more radiating colicky pain and not confined to left flank. Also no sign of hydronephrosis.