Paradoxical Embolism: Renal Infarct Presenting as Abdominal Pain

Files

Authors

Nishant Aggarwal, Beaumont Health Resident
Dana Rector, Oakland University William Beaumont School of Medicine Medical Student
Nicholas J. Lazar, Beaumont Health Resident
Ali Khreisat, Beaumont Health Resident
Florian Bukovec, Beaumont Health

Description

Introduction

Paradoxical thromboembolism refers to thromboembolism originating in venous circulation which traverses directly into systemic circulation in the presence of an intracardiac (such as patent foramen ovale) or pulmonary shunt. Can have variable clinical presentation depending on site of embolization – Embolic stroke: neurological deficits – Intestinal ischemia: abdominal pain – Peripheral arterial embolization: acute limb pain – Renal infarct: flank pain and hematuria.

Conclusion

Simultaneous arterial and venous thrombosis requires hypercoagulable workup, including investigation for malignancy, infection, or thrombophilia. Rarely, venous thromboembolism can directly cause arterial thrombosis by paradoxical embolization. Renal infarction is rare. Usually presents as acute abdominal pain and AKI in patients with risk factors for thrombosis. High index of suspicion is crucial for timely diagnosis given patients may benefit from percutaneous endovascular therapy, if indicated.

Publication Date

10-2022

Keywords

paradoxical embolism, abdominal pain, renal infarction

Disciplines

Internal Medicine

Recommended Citation

Aggarwal N, Rector Dn, Lazar N, Khreisat A, Bukovec F. Paradoxical embolism: renal infarct presenting as abdominal pain. American College of Physicians Michigan Chapter Annual Scientific Meeting; 2022 Oct 13-16; Bellaire, MI.

Comments

American College of Physicians Michigan Chapter Annual Scientific Meeting, October 13-16, 2022, Bellaire, MI.