Sonographic Rim in Acute Renal Cortical Necrosis

Abstract

Ultrasonography is the first line of investigation requested for patients presenting with a clinical features of acute renal failure. Acute renal Cortical Necrosis (ACN) is an uncommon cause of acute renal failure secondary to reduced perfusion to the renal cortex with relative sparing of the medulla. There is limited literature available on early sonographic features of acute cortical necrosis. Ultrasonography finding of hypoechoic renal cortex is a diagnostic feature of acute cortical necrosis. This appearance can be aptly called "Sonographic hypoechoic cortical rim". Bilateral ACN following pancreatitis is an extremely rare entity. Due to rarity of association between pancreatitis and bilateral renal cortical necrosis, authors reported case of 25-year-old male presented with severe abdominal pain, vomiting, reduced urine output, constipation. Ultrasonography revealed normal size kidneys with diffuse circumferential hypoechoic appearance of cortex on both sides. Laboratory investigations demonstrated elevated white blood cell count, raised serum amylase. Diagnosis of ACN secondary to acute pancreatitis was made.