Fig. 38.

A 59-year-old male patient with known congestive heart failure and atrial fibrillation presented with abdominal distention and diffuse abdominal pain to the ER. Axial plane postcontrast abdominal CT image showed a diffuse decrease in the parenchymal enhancement of the left kidney (arrows) and a large right renal infarct with thin cortical enhancement, so-called the cortical rim sign (arrowheads). Noted were dilated small bowel loops (asterisks), which were later surgically confirmed to be secondary to intestinal ischemia