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