Occlusion of the left renal artery resulting in acute infarction in this vasculopathic patient, with absent enhancement of the majority of the left kidney. A few areas of enhancement in the left kidney may be due to a tiny amount of flow preserved in the renal artery. 

Note is made of the common collateral pathway following SMA occlusion, which is likely reconstituted by the pancreaticoduodenal arcade from the celiac artery.