RESUMO
A 72-year-old man with peripheral arterial disease, an atrophic left kidney, and prior right renal chimney stent as part of a complex endovascular abdominal aortic aneurysm repair presented to our emergency department with right flank pain and anuria resulting from right artery occlusion. His serum creatinine on admission was 7.5 mg/dL. Computed tomography angiography 6 days after the onset of his symptoms revealed complete occlusion of the right renal artery stent. Percutaneous thrombectomy was performed restored renal blood flow. The urine flow started the following day, and his serum creatinine decreased to 3.5 mg/dL 7 days after discharge.
RESUMO
Background: Simple renal cysts typically produce no symptoms or signs and are usually detected incidentally on imaging studies for unrelated causes. Massive renal cysts are very rare. Case Report: A 77-year-old female with preexisting chronic kidney disease presented to our hospital for evaluation of hyperkalemia, abdominal distension, and right flank pain. Upon arrival, her vital signs and physical examination were normal. Laboratory data were pertinent for a serum creatinine of 4.8 mg/dL (6 months prior to presentation, serum creatinine was 1.5 mg/dL, and 1 month after discharge, it was 4.6 mg/dL), and hyperkalemia of 6.0 mmol/L. Computed tomography revealed a massive right renal cyst measuring 22 × 11 × 17.5 cm and displacing the intra-abdominal structures. Because of her symptoms, the patient was evaluated by urology for surgical management. The patient refused invasive procedures and chose pain control and monitoring. Conclusion: Noninvasive treatment options for a massive simple renal cyst are limited. Symptomatic treatment and monitoring the cyst size on a regular basis might be helpful for patients who refuse invasive treatment.
