Wunderlich syndrome

Case contributed by Anil Kumar Geetha Virupakshappa
Diagnosis certain

Presentation

Sudden onset of right lower abdominal pain, tender on examination, voluntary guarding.

Patient Data

Age: 80 years
Gender: Female
ct

Acute large right perinephric hematoma is noted with active extravasation of contrast due to a pseudo-aneurysm at the lower pole fat-containing lesion of the right kidney.

dsa

Pre-embolization angiogram study shows contrast filling of the pseudo-aneurysm at the lower pole region of the right kidney which stops completely on coil embolization.

Case Discussion

Spontaneous non-traumatic renal hemorrhage into the subcapsular and perirenal spaces is called Wunderlich syndrome. Angiomyolipomas are the most common benign non-malignant causes for the same, like in our case. The risk of spontaneous hemorrhage increases with the size of the lesion (>4cm size).

Angiographic selective embolization was performed, which was a life-saving procedure for her.

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