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How does Wunderlich syndrome classically present?
Wunderlich syndrome is characterised by flank pain, a flank mass and haemorrhagic shock. This triad of symptoms is known as Lenk's triad.
There is a large left retroperitoneal haematoma with active bleeding from a left renal tumour measuring 9 x 7 x 6.5 cm. The tumour has a large fatty component with abnormal vascularity,compatible with a large angiomyolipoma. Haemoperitoneum is also noted adjacent to spleen.