Abstract

Aim: To investigate the relationship between hypertension and the indentation and compression of the diaphragmatic crus in the renal artery.

Material and Methods: Abdominal computed tomography scans of 304 consecutive adult patients performed for any reason were retrospectively analyzed. Patients with crus indentation or compression on the renal artery were identified. Diaphragmatic crus contact was defined as compression if it caused stenosis more than 50% of the renal artery diameter, and indentation if it caused stenosis less than 50%. If the renal artery originated above the level of the L1-2 intervertebral disc, it was considered as a high origin.

Results: The mean age of women was 51±15.29 and the mean age of men was 52±15.38. Hypertension was present in 29.6% (n=74) of the patients. Diaphragmatic crus indentation (DCI) was detected in 8.4% (n=21) of all patients, and 76.2% (n=16) of these were men. Diaphragmatic crus compression (DCC) (n=3) was detected in 1.2% of all patients, and 67% (n=2) of these were women. Hypertension was present in 67% (n=2) of patients with DCC, all of them were women, and the mean age was 65.5 years. Hypertension was present in 38.1% (n=8) of patients with DCI.

Conclusions: DCI and DCC which can be caused by hypertrophic diaphragmatic crus or high origin of the renal artery, should be included in the etiology of renovascular hypertension. In addition to the presence of renal artery stenosis in a patient with hypertension, the relationship between the renal artery and diaphragmatic crus should also be evaluated.

Keywords: diaphragmatic crus, hypertension, renal artery, renovascular

Copyright and license

Copyright © 1970 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Akkurt Acar D, Çilengir AH, Balaban M, Çamur E, Akdal Dölek B, Işıksalan Özbülbül N. Diaphragmatic crus indentation to the renal artery: Is it a new etiology for renovascular hypertension in adults?. Northwestern Med J. 2025;5(1):9-15. https://doi.org/10.54307/2025.NWMJ.99

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