Page Kidney Resulting From Traumatic Subcapsular Renal Hematoma: A Case Report

Page kidney is an uncommon but clinically important cause of secondary hypertension resulting from external compression of the renal parenchyma, most often due to a subcapsular or perinephric hematoma, leading to reduced renal perfusion and activation of the renin-angiotensin-aldosterone system. We report a case of a 45-year-old Middle Eastern male who presented with acute left flank pain and newly diagnosed severe hypertension following minor blunt trauma. Initial evaluation revealed localized flank tenderness and elevated blood pressure in the absence of hemodynamic instability or significant laboratory abnormalities. Imaging with ultrasonography demonstrated a compressive perinephric collection, while contrast-enhanced computed tomography confirmed a left-sided subcapsular renal hematoma causing significant parenchymal compression without evidence of active bleeding or vascular injury. Based on the clinical and radiological findings, a diagnosis of Page kidney was established. The patient was successfully managed conservatively with close inpatient monitoring, analgesia, and renin-angiotensin system-targeted antihypertensive therapy, resulting in progressive symptom resolution and blood pressure control. Follow-up imaging demonstrated partial hematoma resolution with preserved renal function. This case emphasizes that Page kidney can occur even after low-impact trauma and may present with subtle clinical findings aside from acute hypertension. Early recognition through careful blood pressure assessment and appropriate imaging is critical, as timely conservative management can lead to favorable outcomes and prevent long-term renal damage or persistent hypertension.