Case Author(s): Charles Pringle / F. Dehdashti , 7/7/95 . Rating: #D2, #Q4

Diagnosis: Renal transplant infarction

Brief history:

Status post renal transplant with recent worsening of function.


Sequential 1 minute anterior images.

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View second image(rs). Flow images.

View third image(us). left lower quadrant

View fourth image(ct).

Full history/Diagnosis is available below

Diagnosis: Renal transplant infarction

Full history:

Patient is status post renal transplant in March 1995, now with declining renal function and left flank pain.


The scintigraphic images reveal no significant perfusion uptake or excretion of tracer by the transplant kidney, with increased flow in a rim surrounding the expected site of the transplanted kidney. This is consistent with a nonfunctioning renal transplant graft. Possible etiologies include graft rejection or vascular occlusion.


Ultrasound of 7-3-95 reveals a large perinephric collection with mottled hyperechoic foci. Posterior to this area there is another echogenic mass with peripheral dirty shadowing. This is most consistent with an infected necrotic renal allograft with adjacent hematoma or abscess. CT of 7-5- 95 confirms these findings with necrosis of the renal allograft with a large amount of gas present within this and a large peritransplant fluid collection just anterior to the transplant kidney, which probably represents an abscess.


The patient's abscess subsequently was drained and a large amount of pus was removed.

Major teaching point(s):

A large fluid collection located anterior to the kidney can attenuate the photons and the kidney appears nonfunctioning/poorly functioning. Therefore, a lateral view may be needed to separate the fluid collection from the kidney.

ACR Codes and Keywords:

References and General Discussion of Renal Scintigraphy (Anatomic field:Genitourinary System, Category:Effect of Trauma)

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Case number: rs007

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