How does papillary necrosis cause flank pain?

Updated: Dec 11, 2019
  • Author: Bradley C Gill, MD, MS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Papillary necrosis can cause ureteral obstruction as sloughed papilla pass down the ureter. Analgesic abuse, liver cirrhosis, and diabetes are the most common risk factors for this condition; other known causes are sickle cell disesase, vasculitis, and tuberculosis. The actual sloughing of the renal papilla is caused by vascular ischemia, which leads to coagulative necrosis of the renal medullary pyramids. Diagnosis is aided by cross-sectional imaging. See Papillary Necrosis for more information.

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