Intravascular gas in the transplanted kidney: a sign of extensive graft necrosis.
We encountered a case of transplanted kidney necrosis, with computed tomography (CT) demonstrating multiple areas of intravascular gas within the allograft. The intravascular gas represented air emboli from gas liberated from fermentation by gas-forming organisms in a perinephric abscess. Arterial bleeding accelerated by the wound infection and the resultant large perinephric hematoma caused renal infarction. Gas-forming infection of transplanted organs is associated with a poor graft outcome, which can present as a fulminant clinical course. Intravascular gas should be distinguished from collecting system gas because the former could represent extensive necrosis of the transplanted kidney.
Ishigami
Kousei
K
Department of Radiology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-1077, USA. kousei-ishigami@uiowa.edu
Olsen
Kim M
KM
Hammet
Bradley K
BK
Katz
Daniel A
DA
Wu
You Min
YM
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D000368:Aged; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005740:Gases; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation / Q000000981:diagnostic imaging*; D009336:Necrosis; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging; D013530:Surgical Wound Infection / Q000150:complications; D014057:Tomography, X-Ray Computed
D005740:Gases