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Wunderlich syndrome

Case contributed by Hani Makky Al Salam
Diagnosis certain

Presentation

Right upper quadrant acute pain and tenderness.

Patient Data

Age: 25 years
Gender: Female
ultrasound

Predominantly echogenic lesion involving the upper pole of the right kidney associated with more complex appearing perinephric collection.

ct

CT scan of the abdomen confirms the presence of a fatty lesion in the upper pole of the right kidney consistent with angiomyolipoma complicated by hemorrhage.

Incidental two tiny hepatic hemangiomas.

Case Discussion

Perirenal hemorrhage without a history of trauma complicating an angiomyolipoma is known as Wunderlich syndrome. If perirenal hemorrhage is encountered on ultrasound, a thorough workup should be performed to exclude a bleeding renal cell carcinoma.

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