Abstract
RATIONALE: Post-traumatic renal artery embolism (RAE) represents a rare vascular emergency with diagnostic challenges due to its nonspecific presentation. This study aims to enhance clinical recognition through a comprehensive analysis of a bilateral RAE case and contemporary management strategies. PATIENT CONCERNS: A 23-year-old male was admitted to the Emergency Department of the Second Affiliated Hospital, Zhejiang University School of Medicine, with acute chest and back pain and disturbance of consciousness following blunt abdominal trauma. DIAGNOSES: The diagnostic workup included contrast-enhanced computed tomography angiography and serum biomarkers. INTERVENTIONS: Upon admission to the Emergency Intensive Care Unit, the patient underwent immediate continuous renal replacement therapy, vasoactive drugs, fluid replacement, alkalization of urine, and symptomatic treatment. After the patient's condition improved, the spinal surgery performed thoracic vertebra reduction and internal fixation surgery. OUTCOMES: Serial renal function monitoring demonstrated complete functional recovery. LESSONS: In the evaluation of post-traumatic abdominal pain, RAE should be systematically considered in the differential diagnosis following exclusion of acute surgical abdomen.