A Case of Acute Bilateral Renal Cortical Necrosis Associated with Peritonitis and Intra-abdominal Operation

Korean Journal of Nephrology 2009;28(3):270-274.

Gun Woo Kang, M.D.1, Kwan Kyu Park, M.D.2 and In Hee Lee, M.D.1

Departments of Internal Medicine1 and Pathology2 Catholic University of Daegu School of Medicine, Daegu, Korea

증례 : 복막염 및 장 절제술 후 발생한 급성 신피질 괴사 1예

강건우1, 박관규2, 이인희1

대구가톨릭대학교 의과대학 내과학교실1, 병리학교실2

Abstract

Renal cortical necrosis (RCN) is a rare cause of acute renal failure in which there is a complete or partial destruction of the renal cortex with sparing of the medulla. We report here a case of acute bilateral RCN associated with intra-abdominal operation. A 70-year-old female patient was admitted to our hospital because of abdominal pain secondary to perforated diverticulits in sigmoid colon. A segmental resection of the sigmoid colon and end-to-end anastomosis was performed on the third hospital day. Two days later, she suddenly developed oligo-anuria and she was treated with hemodialysis. A contrast-enhanced abdominal computed tomography scan showed lack of enhancement of the renal cortex with enhancement of the renal medulla. On the 21th hospital day, renal biopsy was done and microscopic examination of the specimen revealed RCN. Since then, she has been on regular hemodialysis for over six months with no signs of renal recovery. Occult sepsis associated with peritonitis and intra-abdominal operation seems to be the most possible etiologic factor of RCN in our patient.

Key Words: Renal cortical necrosis, Kidney failure, Acute