A Case Report on Renal Cortical Necrosis

Abstract

An autopsy case of renal cortical necrosis following total cystectomy and Brickers' operation in a 61 year-old male with recurrent left ureteral tumor, is reported. Following the operation, the patient developed hematuria and his urinary output diminished gradually. In spite of repeated hemodyalysis for 13 times during the period of 24 days of anuria, he died on the 26 th postoperative day. Autopsy revealed complete destruction of all renal cortical tissue, excluding the subcapsular and juxtamedullary zone. Review of the Japanese medical literature revealed that 15 cases were reported up to date, including two survival cases. Some discussionsas to clinical differentiation between renal cortical necrosis and acute tubular necrosis were done. Renal cortical necrosis shoud be suspected if thrombocytopenia, fibrinogenomia and elongation of prothrombin time were present at the onset of acute renal failure and fibrinolytic therapy should be performed before almost fatal intravascular coagulation take place.