Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Allied Health Professionals’ Corner
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Commentary : Patient’s Voice
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guideline
Guidelines
Image in Nephrology
Images in Nephrology
In-depth Review
Letter to Editor
Letter to the Editor
Letter to the Editor – Authors’ reply
Letters to Editor
Literature Review
Nephrology in India
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Allied Health Professionals’ Corner
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Commentary : Patient’s Voice
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guideline
Guidelines
Image in Nephrology
Images in Nephrology
In-depth Review
Letter to Editor
Letter to the Editor
Letter to the Editor – Authors’ reply
Letters to Editor
Literature Review
Nephrology in India
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
View/Download PDF

Translate this page into:

Images in Nephrology
19 (
3
); 125-125
doi:
10.4103/0971-4065.57112

Bilateral renal cortical necrosis in acute pancreatitis

Department of Radiology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, Andhra Pradesh-517 501, India
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, Andhra Pradesh-517 501, India

Address for correspondence: Dr. V. Siva Kumar, Department of Nephrology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, A.P-517 501, India. E-mail: sa_vskumar @yahoo.com

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications and was migrated to Scientific Scholar after the change of Publisher.

A 22-year-old male with no premorbid illness presented to emergency with vomiting, peri umbilical abdominal pain with pain radiating to the back following an alcoholc binge. He developed oliguria followed by anuria over two days. On examination, he was hemodynamically stable (BP – 120/80 mm of Hg) and had tenderness in the epigastrium and right hypochondriac areas. Investigations revealed neutrophilic leucocytosis (14200 per μl), severe renal failure (Serum creatinine: 13.4 mg/dl) and elevated pancreatic enzymes (serum amylase: 397 U/L, lipase 210 U/L, normal values being 20-96 U/L and 3-43 U/L respectively), elevated LDH (1802 U/L, normal being 115-221 U/L). Contrast enhanced Computed tomography of the abdomen [Figure 1] revealed diffuse and bilateral cortical hypodense areas surrounded by capsular enhancement in both kidneys, which is characteristic of renal cortical necrosis. He received general supportive management, antibiotics and dialysis support. Patient left the hospital against advice on the third hospital day.

Contrast enhanced CT of the abdomen showing diffuse hypodense areas in the cortex surrounded by capsular enhancement in both the kidneys
Figure 1
Contrast enhanced CT of the abdomen showing diffuse hypodense areas in the cortex surrounded by capsular enhancement in both the kidneys

Discussion

Bilateral cortical necrosis is a rare, often irreversible form of acute tubular necrosis. In a study on acute renal failure from north India, the incidence reported was 3.8%.[1] Only eight cases of bilateral cortical necrosis following acute pancreatitis were reported so far in the literature.[2] Cortical necrosis generally results from decreased blood supply within the microcirculation of renal cortex that follows septic shock or volume depletion. However, its cause remains elusive in the presence of normotension. It was ascribed to the release of vasoactive or cytotoxic substances during pancreatitis.[23] Interestingly, our patient was normotensive through out. In view of its rarity, this entity is reported.

References

  1. , , , . Acute renal cortical necrosis: a study of 113 patients. Ren Fail. 1994;16:37-47.
    [Google Scholar]
  2. , , . Acute renal failure following necrotico hemorrhagic pancreatitis. Kidney Int. 2008;74:975-6.
    [Google Scholar]
  3. , , , . Acute pancreatitis and Renal cortical necrosis. Nephrol Dial Transplant. 1990;5:542-4.
    [Google Scholar]

Fulltext Views
336

PDF downloads
312
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections