Acute Renal Infarction Secondary to Superior Polar Artery Thrombosis: A Case Report

Acute renal infarction is a rare condition, often misdiagnosed due to a nonspecific presentation. Anatomical variants of renal arteries may predispose to atypical infarction patterns and influence clinical outcomes. We report a 55-year-old Thai male patient who presented with sudden-onset severe left iliac fossa pain. Initial evaluation revealed leukocytosis, proteinuria, microscopic hematuria, and elevated lactate. Contrast-enhanced computed tomography demonstrated acute thrombosis of a variant superior polar artery with resultant wedge-shaped infarction of the upper renal pole. The patient had early bifurcation of the left main renal artery into dominant superior polar and inferior arteries. Treatment consisted of systemic anticoagulation with unfractionated heparin followed by enoxaparin. The patient recovered without complications, maintaining normal renal function at follow-up. This case highlights the importance of recognising renal infarction in patients with acute abdominal pain, particularly when anatomical variants are present. Early diagnosis through appropriate imaging and prompt anticoagulation can preserve renal function and prevent complications. Clinicians should maintain a high suspicion for renal infarction in patients with sudden severe pain and suggestive laboratory findings.