Traumatic occlusion of renal artery: CT and angiography

Four cases of traumatic renal artery occlusion are reported. A direct blow to the abdomen was considered to have caused renal artery occlusion in two cases. They were severely injured and had macroscopic hematuria. Aortography revealed an abrupt cut-off type of obstruction of the renal artery. In the other two, a rapid decelerating-type of injury resulted in damage to the intima of the renal artery. They showed almost no outward signs of injury and no macroscopic hematuria. Aortography disclosed a tapered occlusion of the renal artery. CT showed the rim sign between the seventh day and sixth week before the compromised kidney became apparent. It had disappeared by the time follow-up CT revealed contraction. One patient developed hypertension, which subsided after nephrectomy. CT findings of the patient suggested the possibility of predicting hypertension as a sequelae of acute renal artery occlusion.