The Wunderlich syndrome is a rare condition, where spontaneous renal haemorrhage occurs into the subcapsular and perirenal spaces 2.
The Wunderlich's syndrome is clinically characterized by the Lenk's triad which are
- acute flank pain
- a flank mass and
- hypovolemic shock
- neoplastic :
- non-neoplastic :
Haemorrhage is seen in perinephric region, often with a primary lesion seen within the kidney e.g. angiomyolipoma, renal cell carcinoma etc.
Treatment and prognosis
If the haemorrhage is self limiting and patient is responsive to fluid resuscitation, patient can be managed conservatively. Angiographic selective embolization is also recommended. In hemodynamically unstable patients, however emergent nephrectomy (partial / total) is advised3.
It is named after the German physician Carl Reinhold August Wunderlich
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- 1. Sparks D, Chase D, Thomas D et-al. The Wunderlich's syndrome secondary to massive bilateral angiomyolipomas associated with advanced tuberous sclerosis. Saudi J Kidney Dis Transpl. 2011;22 (3): 534-7. Saudi J Kidney Dis Transpl (link) - Pubmed citation
- 2. Katabathina VS, Katre R, Prasad SR et-al. Wunderlich syndrome: cross-sectional imaging review. J Comput Assist Tomogr. 35 (4): 425-33. doi:10.1097/RCT.0b013e3182203c5e - Pubmed citation
- 3. Morgentaler A, Belville JS, Tumeh SS et-al. Rational approach to evaluation and management of spontaneous perirenal hemorrhage. Surg Gynecol Obstet. 1990;170 (2): 121-5. - Pubmed citation
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