Renal-splanchnic steal

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HEMODYNAMIC detours resulting from vascular occlusive disease are currently the object of great interest. Recently we have examined a young hypertensive patient in whom studies have yielded considerable evidence indicating that a renal-splanchnic steal is present and functioning.

Report of a Case

First admission to the hospital. A 31-year-old white woman with a history of frequent headaches, flushing, and diaphoresis, for six months, was first admitted to the Cleveland Clinic Hospital on December 28, 1965. Several weeks after the onset of the symptoms, believing that she might be pregnant, she consulted a physician. Her blood pressure was 195/128 mm Hg. Investigation disclosed Escherichia coli infection of the urinary tract and a negative pregnancy test. Four months previous to this episode she consulted another physician and underwent laparotomy and wedge resection of a single right ovary for suspected Stein-Leventhal syndrome; the blood pressure at that time was normal.

In December 1965, physical examination revealed an abdominal bruit. Angiograms obtained at that time demonstrated complete occlusion of the celiac axis, a dilated left colic “wandering” artery, and questionable stenosis of one of two left renal arteries. Late that month she was admitted to the Cleveland Clinic Hospital for further angiographic evaluation. The blood pressure was 172/122 mm Hg. The retinal arteries showed constriction but no exudates or hemorrhages. A high-pitched continuous bruit was present in the left upper quadrant, and a systolic bruit in the right upper quadrant. Significant laboratory findings included 0.36 g of protein per liter of urine, and . . .



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