587 Published by Bali Medical Journal | Bali Medical Journal 2021; 10(2): 587-590 | doi: 10.15562/bmj.v10i2.2319 CASE REPORT ABSTRACT Post-traumatic renal artery thrombosis secondary to blunt abdominal trauma: a rare case report Harry Galuh Nugraha 1* , Eppy Buchori Aristiady 1 , Hilman 1 , Dian Komala Dewi 1 , Leni Santiana 1 , Puspita Arum 2 Background: Blunt abdominal trauma is one of the leading causes of morbidity and mortality among populations worldwide. However, renal artery injury due to blunt abdominal trauma is a rare occurrence. In this case, a patient who sufered multiple trauma was found in the emergency department, including blunt abdominal trauma, after a motor vehicle accident. Case report: A 13-year-old boy with multiple trauma was referred to our emergency department, with the primary consideration being to lose consciousness 3 hours before admission due to a trafc accident. After receiving examination, there was no evidence of abdominal bruising, whereas the results of the head CT scan show epidural hemorrhage. After four days of treatment, the urea and creatinine serum levels increased, abdominal CT scan shows right renal infarction suggestive of right renal arterial rupture. The patient was diagnosed with a moderate head injury and right renal trauma AAST grade IV. The patient was referred to the interventional radiology unit. The endovascular revascularization techniques were performed with renal artery stent placement and vasodilator (nitroglycerin) fush into the renal artery before stent placement. Renal artery stenting placement performed on main right renal artery demonstrates the absence of intraluminal defects and substantially blood fow was established, abdomen CT Scan shows an enhancement on right renal parenchyma which mean right kidney vascularization appears to be improved with the return of glomerular fltration rate to normal value at the time the patient was discharged. Conclusion: Traumatic renal artery thrombosis is a rare occurrence with devastating consequences if any imaging is missed. Endovascular therapy plays a signifcant role in the treatment of renal artery thrombosis with a better prognosis. Keywords: Abdominal blunt trauma, renal artery injury, renal artery thrombosis. Cite This Article: Nugraha, H.G., Aristiady, E.B., Hilman., Dewi, D.K., Santiana, L., Arum, P. 2021. Post-traumatic renal artery thrombosis secondary to blunt abdominal trauma: a rare case report. Bali Medical Journal 10(2): 587-590. DOI: 10.15562/bmj. v10i2.2319 1 Medical doctor, Faculty of Medicine- Universitas Padjadjaran, Bandung, Indonesia; 2 Resident Radiology, Faculty of Medicine- Universitas Padjadjaran, Bandung, Indonesia. *Corresponding author: Harry Galuh Nugraha; Medical doctor, Faculty of Medicine- Universitas Padjadjaran, Bandung, Indonesia; hg.nugraha@gmail.com Received: 2021-03-13 Accepted: 2021-07-01 Published: 2021-07-09 587 Published by Bali Medical Journal Bali Medical Journal (Bali MedJ) 2021, Volume 10, Number 2: 587-590 P-ISSN.2089-1180, E-ISSN: 2302-2914 Open access: www.balimedicaljournal.org INTRODUCTION Abdominal trauma can be divided into blunt and penetrating trauma. Blunt abdominal trauma is one of the leading causes of morbidity and mortality among populations worldwide. Blunt trauma can afect any intraabdominal organ, and the injuries may not always be apparent clinically. Tis condition is especially the case in severe polytrauma. Te renal is the most commonly injured organ in children and adolescents, accounting for more than 60% of genitourinary injuries and 10–20% of blunt abdominal injuries. Most renal trauma in children is minor and occurs afer the age of 5 years, but increasing age is associated with worsening severity of injuries and multisystem injuries. 1,2 Renal artery thrombosis is a rare pathology that may be overlooked when evaluating impaired renal function post- trauma. It is the formation of a blood clot in one or both of the arteries supplying blood to the kidneys, leading to decreased renal perfusion and may result in kidney injury or failure. Tis case report describes that the prompt and accurate diagnosis is essential in such patients, hopefully resulting in timely treatment and rapid recovery with minimal or no morbidity. 2,3 Te radiologist’s role is critical in assessing patients with renal artery thrombosis and establishing accurate diagnoses. Figure 1. Contrast-enhanced multi-detector CT during an arterial phase on axial, coronal and coronal with reconstruction position. Te CT scan showed a signifcantly lower enhancement of the right renal artery (blue arrow). Te absence of the nephrogram phase revealed a thrombus in the right renal artery and renal subscapular hematoma (yellow arrow).