A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report

作者：Tao Ge, Zhu ZhengCai, Jinfeng Wang, Wenjiao Zhou, E Song, Shengxing Tang · 发表于：Journal of Medical Case Reports · 年份：2022 · DOI：10.1186/s13256-022-03608-z · 被引用次数：8 · 研究领域：Aortic Thrombus and Embolism、Atrial Fibrillation Management and Outcomes、Acute Kidney Injury Research

BACKGROUND: Atrial fibrillation is one of the most common arrhythmias. The main thrombotic complication of arterial fibrillation is ischemic stroke, but it can also cause acute renal infarction from embolization. The low incidence and nonspecific clinical manifestations of acute renal infarction make it difficult to diagnose, often leading to either delayed diagnosis or misdiagnosis. Due to its rarity, more efficient treatment guidelines are helpful for the management of acute renal infarction related to the thromboembolic complication of arterial fibrillation. CASE REPORTS: We report a case of acute renal infarction due to underlying arterial fibrillation, where a novel interventional therapeutic method was used. A 66-year-old Chinese man with arterial fibrillation, not on anticoagulation due to the patient's preference, and coronary artery disease post-percutaneous coronary intervention to left anterior descending artery about 1 year ago, was currently on dual antiplatelet therapy. He suddenly developed intermittent and sharp left-sided abdominal pain and was found to have an acute left renal infarction on computed tomography scan. Angiogram showed acute occlusion of the left renal artery due to thromboembolism. For this patient, a combination method of local thrombus aspiration, angioplasty, and infusion of nitroglycerin and diltiazem were used, restoring blood flow to the left kidney. After recovery, the patient was discharged on aspirin, clopidogrel, and warfarin. At 6 m...