Perinephric haematoma causing refractory hypertension in a 17-year-old male

New-onset arterial hypertension is a well-recognised complication of kidney trauma. Cases have been described in young healthy athletes with hypertension arising years after sports-related trauma. The pathophysiology of this disease is thought to arise from intrarenal arterial stenosis resulting from rapid deceleration during the initial injury. This leads to arterial obstruction and ischaemia with increased secretion of renin, eventually leading to elevated blood pressure. Though hypertension in these cases is generally gradual in onset and long-standing, it can also rise acutely, leading to malignant hypertension. We present the case of a 17-year-old male who presented with refractory hypertension following blunt trauma to his left kidney during a recent sporting injury. This is followed by a discussion of the relevant literature in this area to date, highlighting the key challenges involved in the management of these patients.