title: Acute renal infarction resulting from fibromuscular dysplasia: a case report.
abstract: BACKGROUND
  Acute abdominal pain is one of the most frequent complaints evaluated at emergency departments. Approximately 25 % of abdominal pain patients discharged from emergency departments are diagnosed with undifferentiated abdominal pain. One possible reason for acute abdominal pain is renal infarction. Diagnosis is difficult and often late.
  
  
  METHODS
  A white, 33-year-old, previously healthy Finnish man came to our emergency department because of acute abdominal pain. After evaluation and follow-up he was discharged the next day with a diagnosis of undifferentiated abdominal pain. He returned a day later and was diagnosed with renal infarction. Appropriate therapy was initiated in the nephrology ward. Further tests confirmed a diagnosis of renal infarction as a result of fibromuscular dysplasia. He recovered well and was discharged on the tenth day of hospitalization. His renal function was normal.
  
  
  CONCLUSIONS
  Renal infarction is rare and should be considered if a patient with intense flank pain has no sign of urolithiasis or pyelonephritis. Contrast-enhanced computer tomography and assay of lactate dehydrogenase are recommended. The optimal treatment is still uncertain. Every patient discharged with undifferentiated abdominal pain should be given clear instructions as to when it is necessary to return to the emergency department.
authors.affiliation: Department of Cardiology, Kanta-Häme Central Hospital, Ahvenistontie 20, 13530, Hämeenlinna, Finland. harri.saarinen@fimnet.fi.
authors.forename: Harri Juhani
authors.initials: HJ
authors.lastname: Saarinen
authors.affiliation: Department of Emergency Medicine, Kanta-Häme Central Hospital, Ahvenistontie 20, 13530, Hämeenlinna, Finland.|Medical School, University of Tampere, 33014, Tampere, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Palomäki
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology; D000792:Angiography; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging* / Q000209:etiology; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed
keywords: Abdominal pain; Fibromuscular dysplasia; Kidney; Renal artery; Renal infarction; Thrombosis