Ultrasound images of Renal vein thrombosis

The occlusion may be partial or complete and the venous Doppler spectrum may therefore be absent (Fig.ultrasound images below).
If venous thrombosis is partial, the arterial spectral waveform becomes very pulsatile, with reverse end diastolic flow; in the clinical setting of an oliguric patient with a tender graft in the early postoperative period, this is almost pathognomonic for RVT.
During the early stages, when thrombosis is incomplete, venous flow may be seen in the kidney, but the artery is of reduced velocity. The ultrasound findings of renal vein thrombosis may be indistinguishable from severe rejection; however venous flow is generally unaffected in the latter. Thrombosis is rare, occurring typically in the immediate postoperative period.  It may be associated with a faulty venous anastomosis, secondary to compression of the vein, for example by a large, perivenous collection, or the patient may have an increased thrombotic tendency for a number of reasons.
Renal vein thrombosis. (A) Poor transplant perfusion, with scanty demonstration of arterial flow.
Ultrasound images of The same vessels demonstrate reversal of flow at the end of the cardiac cycle
ultrasound images The bidirectional flow is demonstrated on the spectral trace.
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