title: [Flank pain caused by a renal artery dissection].
abstract: BACKGROUND
  A spontaneous renal artery dissection is a very rare diagnosis. The clinical presentation can vary and its course can be atypical. There are no guidelines available regarding treatment; however, the options are a conservative (medication) or interventional (radiological or surgical) approach.
  
  
  METHODS
  A 45-year-old man presented to the emergency department with hypertensive urgency after earlier episodes of flank pain. The cause appeared to be a spontaneous bilateral renal artery dissection with infarction. After a multidisciplinary consultation, the decision was made to manage the patient conservatively since symptoms had subsided, blood pressure was acceptable and renal function remained stable. Eventually, kidney function restored to normal and CT images showed almost complete recovery of the previously damaged renal parenchyma.
  
  
  CONCLUSIONS
  This case demonstrates that in the event of renal artery dissection, a conservative medication policy may be a good option in clinically stable patients with non-deteriorating renal function. Timely recognition and adequate follow-up are important to prevent serious complications, such as renal ischaemia or renal infarction that could necessitate a nephrectomy.
authors.affiliation: Martini Ziekenhuis, Groningen.
authors.forename: J C
authors.initials: JC
authors.lastname: Karper
authors.forename: W M T
authors.initials: WM
authors.lastname: Janssen
authors.forename: J C
authors.initials: JC
authors.lastname: Breek
authors.forename: R
authors.initials: R
authors.lastname: Oosterhof-Berktas
authors.forename: J
authors.initials: J
authors.lastname: Gravendeel
authors.forename: T K
authors.initials: TK
authors.lastname: Kremer Hovinga
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis*; D021501:Flank Pain / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007238:Infarction / Q000175:diagnosis*; D007668:Kidney; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000002:abnormalities*