Contrast enhanced ultrasound (CEUS) in the diagnosis of post-partum bilateral renal cortical necrosis: a case report and review of the literature

Renal cortical necrosis is a rare condition with complex pathogenesis. There is no consensus over the best investigative modality for an initial diagnosis that is often in the context of acute renal failure. The applications of ultrasound contrast are ever growing, particularly with regard to the assessment of abdominal organs. Here, we present a case of post-partum bilateral renal cortical necrosis affecting bilateral native kidneys and the subsequent use of contrast enhanced ultrasound in confirming this diagnosis. The sonographic appearance was found to correlate with the patients’ clinical presentation and other imaging findings. Secondarily, this allowed for appropriate and timely medical management and establishes the utility of ultrasound contrast in this clinical scenario. Contrast enhanced sonographic assessment should be considered early in patients with suspected renal vascular compromise. It is a safe, easy and efficacious investigative modality to stratify those patients with renal cortical necrosis from those with potentially reversible medical causes.