case_images: PMC10762308_01
case_images: Axial (A) and coronal (B) pelvic CT scan showed increased vascular density in the transplanted kidney.
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case_images: PMC10762308_01_fmed-10-1275188-g001.jpg
case_images: fig1
case_images: On admission, a pelvic CT scan was performed for the patient to further confirm the diagnosis, which showed multiple small stones in pelvis and calyceal system, mild ureteral dilatation and effusion, multiple exudation of the right iliac fossa involving the peritoneum; the vascular scanning density of transplanted kidney was increased (Figures 1A,B).
case_images: (A) Doppler ultrasound on admission suggested the blood flow of the transplanted renal vein was blocked. (B) Contrast-enhanced ultrasound before anticoagulation showed the contrast agent passing through the transplanted renal vein.
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case_images: fig2
case_images: There is a filling defect with non-enhancing hypoechoic mass of approximately 45 mm x 8 mm in size with in the renal vein lumen, which led to a maximum venous stenosis of >70% (Figures 2A,B).
case_images: (A) Four days after anticoagulation, Doppler ultrasound showed a reduction in the volume of the thrombus within the main trunk of the grafted kidney vein compared to before. (B) Anticoagulant therapy for 11 days, the thrombus in the vein lumen of the transplanted kidney disappeared.
case_images: fmed-10-1275188-g003.jpg
case_images: PMC10762308_01_fmed-10-1275188-g003.jpg
case_images: fig3
case_images: Five days after treatment, the ultrasound of the transplanted kidney suggested that the size of the hypoechoic mass in the lumen of the renal vein was approximately 13 mm x 4 mm (Figure 3A). On the 10th day of treatment, a repeat ultrasound of the transplanted kidney showed a clear renal vein wall with continuous echogenicity, the hypoechoic mass in the original lumen was not shown (Figure 3B), and the blood creatinine decreased to 319 mumol/L.