Figure 1
(a) US coronal oblique plane on the left flank, demonstrating enlargement and increased cortical echogenicity of the left kidney, with a thick perirenal hematoma (arrowheads). (b) US demonstrating an associated left adrenal hematoma, with hypoechoic areas of liquefaction.
Figure 2
(a) US axial plane of the left flank, demonstrating the enlarged left kidney (LK) and left renal vein (LRV), filled with hypoechoic content. (b) US axial plane of the abdomen, demonstrating the asymmetric kidneys (RK, LK) and the inferior vena cava (IVC) filled with hypoechoic content. (c) US sagittal plane demonstrating the enlarged suprarenal IVC, filled with hypoechoic content (arrows).
Figure 3
(a) Color Doppler on the left kidney (LK) revealing an absence of venous flow in the lesser tributary veins and in the main renal vein, and a reduced flow in the main renal artery, with exuberant arterial flow in the contralateral renal artery (RRA), aorta (Ao) and iliac branches (I). (b) Color and spectral Doppler on the left kidney revealing a decreased diastolic flow and increased resistance index (RI) in the renal artery.
Figure 4
(a) Follow-up US two weeks later revealing a reduction in the perirenal hematoma thickness (arrowheads), and a decreased kidney cortico-medullary differentiation, with an intermedullary streaking pattern (arrows). (b) Doppler imaging two weeks later demonstrating an almost complete loss of vessel flow in the left kidney.
Figure 5
(a) US one year later revealing an utterly atrophic left kidney. (b) US one year later revealing a filiform hypoechoic IVC (arrows).