Julia R. Fielding, M.D. Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts

28 Year-old Male Status Post Motorcycle Accident

A 28 year-old man driving a motorcycle collided with an automobile and suffered multiple injuries to his right chest and abdomen. On presentation to the emergency room, he had microscopic hematuria and right upper quadrant pain. An arteriogram was performed as part of the diagnostic work-up (Figure 1). A CT scan was obtained one week following the initial injury as part of careful follow-up (Figure 2).

The arteriogram demonstrates a large filling defect within the right renal artery indicative of acute thrombotic occlusion. The CT examination obtained one week after the injury shows a low density rim of renal cortex with a higher density central area, the pattern of cortical necrosis.