Spontaneous renal artery dissection complicated by renal infarction

INTRODUCTION: Renal artery dissection is a rare cause of abdominal pain. The renal arteries are the commonest site of primary dissection involving visceral vessels but spontaneous bilateral dissection is extremely rare. PRESENTATION OF CASE: We present a case of spontaneous bilateral renal artery dissection in a previously fit 43-year-old man who presented with right iliac fossa pain. He was treated conservatively with anticoagulation for 6 months, with resolution of the dissections on imaging at 6-month follow-up. DISCUSSION: The presentation of spontaneous renal artery dissection is non-specific, making it a diagnostic challenge. Computed Tomography angiography is now the gold standard for diagnosis and follow-up of these patients. CONCLUSION: This case highlights the importance of considering other causes of abdominal pain in a young man with normal initial investigations and the role of conservative management.