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December 5, 1977

Splenic Cyst Causing Hypertension by Renal Compression

JAMA. 1977;238(23):2528-2529. doi:10.1001/jama.1977.03280240074029

HYPERTENSION caused by renal compression is a phenomenon that has been shown to be dependent on the renin angiotensin system in many cases.1,2 We have recently seen a young man with hypertension associated with a large splenic cyst that induced unilateral renal compression. Renin production was limited to the compressed kidney, and cure of the hypertension was accomplished by splenectomy.

Report of a Case  A 35-year-old man was noted in 1972 to have persistent hypertension, with diastolic blood pressure in the range of 90 to 110 mm Hg. Therapy with chlorothiazide was begun, and this normalized his blood pressure. In 1974, an intravenous pyelogram showed noticeable displacement of the upper collecting system on the left (Fig 1).The history included an episode of abdominal trauma that occurred during an automobile accident 15 years prior to admission. Abdominal pain at that time was localized to the left upper quadrant and