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RADIOLOGY: KIDNEY: Case# 33024: END-STAGE RENAL DZ- NATIVE RENAL VEIN THROMBOSIS. Forty-one year old female approximately six weeks status post right renal transplant. Several weeks status post peritoneal dialysis catheter removal who presents with left mid and upper abdominal pain. 1) Focal left mid mesenteric fluid collection which may represent the sequellae of a thrombosed superior mesenteric vein branch or hematoma, or possibly as the sequellae of pancreatitis(the focal fluid collections in the body of the pancreas are consistent with pseudocysts, but cannot be connected with the mesenteric fluid collection.In addition, there is no definite evidence of ongoing acute pancreatitis to be certain of pancreatitis as the etiology). The small bowel which this mesentery supplies is also abnormal with abnormal wall thickening and enhancement which can be seen in venous congestion and ischemia. 2) Bilateral native renal vein thromboses, the right extending into the IVC. 3) Subcapsular hepatic fluid collection as described above of uncertain etiology. 4) Small to moderate amount of free intraperitoneal fluid may be related to residual dialysate from previous peritoneal dialysis; however, enhancing peritoneum which can be seen in inflammatory or infectious processes is non-specific. 5) Probable small lymphocele posterior to the renal transplant.

Peter Anderson
kidney, radiology