Paradoxical Pulmonary Embolism in a Patient with Bilateral Renal Infarction: The Role of Contrast-enhanced Ultrasound Imaging

J Cardiovasc Echogr. 2022 Jul-Sep;32(3):180-182. doi: 10.4103/jcecho.jcecho_25_22. Epub 2022 Nov 16.

Abstract

We present the case of a 52-year-old male who was admitted to the hospital for a bilateral pulmonary embolism. On the 5th day of hospitalization, an acute kidney injury (AKI) occurred. A transesophageal echocardiogram was performed and it demonstrated a large patent foramen ovale with a consistent right-to-left shunt. Contrast-enhanced ultrasound (CEUS) was performed and it demonstrated multiple bilateral renal ischemic areas. CEUS represents a valid alternative to computed tomography or magnetic resonance to confirm the diagnosis of bilateral kidney infarction, especially in patients who experience an AKI.

Keywords: Acute kidney injury; paradox embolism; patent foramen ovale; pulmonary embolism; renal kidney embolism.

Publication types

  • Case Reports