Transient Hypertension Associated with Closed Renal Injury

Abstract

Summary A transient hypertension was found in 6 out of 60 patients with mild closed unilateral renal trauma. It is a benign condition, spontaneously resolving. The pattern of the hypertension suggests that it may be caused by renal ischaemia due to vascular compression by haematoma.

Renal Parenchymal Compression Producing Hypertension (Page Kidney)

“…This agrees with Page's assertion that the greater restriction of expansion in the subcapsular compartment will produce greater renal compression (Engel and Page, 1955). Acute haematomas may provide a similar effect but often resolve spontaneously (Jameson, 1973). Only rarely have other space occupying lesions been implicated (Schroeder and Correa, 1966;Sos et al, 1973).…”

At the bottom of the differential diagnosis list: unusual causes of pediatric hypertension

“…When posttraumatic hypertension occurs, the mechanisms may include ischemia from arterial stenosis or occlusion; parenchymal compression due to perirenal hematoma, urinoma or scar; and traumatic arteriovenous fistulae [28]. Initial management of renal trauma is aimed at preserving renal function and minimizing patient morbidity.…”

Page Kidney: A Curable Form of Arterial Hypertension

“…Small, asymptomatic hematomas may be managed ex pectantly and the good success rate of nonoperative management emphasizes that a constricting perirenal hematoma causing hypertension can be reabsorbed with remission of hypertension [16][17][18]. Some perirenal he matomas fail to be reabsorbed: factors leading to chronicity are not clear: although it is unproved, coexisting urine extravasation may contribute to fibrosis [19].…”