Case report: An unusual presentation of renal hypertension after damage control surgery

• Published in: International journal of surgery case reports Vol. 82; p. 105872
• Main Authors: Galos, Peter, Hultström, Michael, Creusen, Angeliki Dimopoulou, Eggertsen, Gösta, Urdzik, Jozef, von Seth, Magnus
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2021; Elsevier
• Subjects: Case Report; Hemorrhage; Hyperreninemia; Hypertension; Medicin och hälsovetenskap; Page kidney; Renin; Trauma; Hypertension; Page kidney; Case report; Renin; Hyperreninemia; Trauma; Hemorrhage
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.105872

•A case of surgical drape packing induced hypertensive crisis in a trauma patient.•Compression of the kidney from the surgical drapes induced hypersecretion of renin.•The hypertensive crisis was resolved after removing the surgical drapes.•Rule out renin-mediated hypertension in hypertension following abdominal packing.
Hypertensive crisis may be a life-threatening condition to any patient and represents an even more serious condition in trauma patients following severe hemorrhage.
We present a case were surgical drape packing induced hypertensive crisis in a trauma patient, recently resuscitated from abdominal hemorrhage.
We argue that direct compression of the kidney by the surgical drapes induced hypersecretion of renin with a mechanism equal to Page kidney. The hypertensive crisis as well as the hyperreninemia was resolved after removing the surgical drapes, and the patient’s condition returned to normal without any sequelae.
We encourage considering this unusual but important complication when packing of the abdomen has been carried out, and strongly recommend ruling out renin-mediated hypertension as a cause of post-operative hypertension in such cases.