Anticoagulation Over Revascularization: Managing Traumatic Renal Artery Thrombosis in an Adolescent Trauma Patient

Geetika Anand, Manoj Sonkar, Udit Patel, Prena Minz

Abstract: Background: Traumatic renal artery thrombosis (TRAT) is an uncommon but potentially severe vascular consequence of blunt abdominal trauma. Because early symptoms are often minimal, diagnosis is frequently delayed, and the appropriate management strategy- particularly the point at which antifibrinolytic therapy should give way to anticoagulation ? remains a subject of ongoing debate. Case Presentation: A male adolescent presented twelve hours after a road traffic accident with left flank pain. His initial FAST scan was only minimally positive, his abdominal girth stayed stable on serial measurement, and a mild drop in haemoglobin settled on its own with tranexamic acid and immobilisation. It was only on contrast-enhanced CT that the true picture emerged: a non-enhancing left kidney with absent opacification of the left renal artery, confirming TRAT. Once the thrombosis was identified, tranexamic acid was stopped, and anticoagulation began on day two- first enoxaparin, then a transition to warfarin with aspirin. The patient stayed haemodynamically stable throughout, his renal function held up, and he was discharged in good condition. Conclusion: For hemodynamically stable, unilateral TRAT, conservative management with anticoagulation is a reasonable alternative to revascularisation. Antifibrinolytic therapy should be discontinued as soon as arterial thrombosis is confirmed, and clinicians should bear in mind that a thrombus can mask an underlying renal laceration- a real hazard if revascularisation is attempted.

Keywords: Renal Artery Obstruction; Blunt Trauma abdomen, Nonpenetrating; Tranexamic Acid; Anticoagulants; Adolescent; Renal artery thrombosis

How to Cite?: Geetika Anand, Manoj Sonkar, Udit Patel, Prena Minz, "Anticoagulation Over Revascularization: Managing Traumatic Renal Artery Thrombosis in an Adolescent Trauma Patient", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 1532-1534, https://www.ijsr.net/getabstract.php?paperid=SR26923125149, DOI: https://dx.doi.org/10.21275/SR26923125149

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