Spontaneous hemorrhage in polycystic renal disease

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Severe left loin pain and hematuria. Known familial polycystic disease with longstanding reduced renal function.

Patient Data

Age: 45 years
Gender: Male

CT KUB without IV radiographic contrast as renal colic suspected by clinicians

Typical large polycystic kidneys (PCK) with hematoma in a lower pole cyst in the left kidney that has ruptured out into the subcapsular and perinephric spaces. Spontaneous hemorrhage into PCK cysts is well recognized but rarely is the bleeding so dramatic as in this case.

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