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Laparoscopic treatment of a spontaneously ruptured kidney (wunderlich syndrome).

Bretterbauer KM, Markić D, Colleselli D, Hruby S, Magdy A, Janetschek G, Mitterberger MJ - Case Rep Urol (2015)

Bottom Line: Spontaneous, nontraumatic retroperitoneal hemorrhage or Wunderlich syndrome (WS) is a rare but potential life-threatening condition.If angioembolization is not available open surgery is in most cases the preferred approach.We present a patient with a spontaneously ruptured kidney due to a central renal angiomyolipoma, which was treated by laparoscopic nephrectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University Clinics Salzburg, 5020 Salzburg, Austria.

ABSTRACT
Spontaneous, nontraumatic retroperitoneal hemorrhage or Wunderlich syndrome (WS) is a rare but potential life-threatening condition. In most patients a bleeding renal neoplasm is the cause of the retroperitoneal hematoma. The management of this condition includes a conservative approach in the hemodynamically stable patients and active treatment in the unstable patients. Active treatment includes angioembolization or surgery. If angioembolization is not available open surgery is in most cases the preferred approach. We present a patient with a spontaneously ruptured kidney due to a central renal angiomyolipoma, which was treated by laparoscopic nephrectomy.

No MeSH data available.


Related in: MedlinePlus

Arterial phase of the computerized tomography showing the ruptured kidney with the central renal angiomyolipoma with retroperitoneal hematoma and precaval right renal artery. 116 × 87 mm (150 × 150 DPI).
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fig2: Arterial phase of the computerized tomography showing the ruptured kidney with the central renal angiomyolipoma with retroperitoneal hematoma and precaval right renal artery. 116 × 87 mm (150 × 150 DPI).

Mentions: A 74-year-old female patient presented herself at the emergency room because of sudden and now constant pain in the right lumbar region. Physical examination was normal except mild tenderness in the right lumbar region. The patient denied any trauma and had no premedication. Initial hemoglobin level was 10.2 g/dL, hematocrit 29%, creatinine value 0.7 mg/dL, and eGFR >70 mL/min. The urine showed no macroscopic hematuria. The ultrasound (US) examination showed a hypoechogenic mass around the right kidney and a 10 cm central renal lesion. The consecutive computerized tomography (CT) revealed ruptured kidney due to a 10 cm central renal AML with bleeding in the tumour and a large perinephric hematoma around the right kidney (Figure 1). The hematoma was confined by Gerota's fascia and also a single precaval right renal artery was noticed (Figure 2).


Laparoscopic treatment of a spontaneously ruptured kidney (wunderlich syndrome).

Bretterbauer KM, Markić D, Colleselli D, Hruby S, Magdy A, Janetschek G, Mitterberger MJ - Case Rep Urol (2015)

Arterial phase of the computerized tomography showing the ruptured kidney with the central renal angiomyolipoma with retroperitoneal hematoma and precaval right renal artery. 116 × 87 mm (150 × 150 DPI).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374331&req=5

fig2: Arterial phase of the computerized tomography showing the ruptured kidney with the central renal angiomyolipoma with retroperitoneal hematoma and precaval right renal artery. 116 × 87 mm (150 × 150 DPI).
Mentions: A 74-year-old female patient presented herself at the emergency room because of sudden and now constant pain in the right lumbar region. Physical examination was normal except mild tenderness in the right lumbar region. The patient denied any trauma and had no premedication. Initial hemoglobin level was 10.2 g/dL, hematocrit 29%, creatinine value 0.7 mg/dL, and eGFR >70 mL/min. The urine showed no macroscopic hematuria. The ultrasound (US) examination showed a hypoechogenic mass around the right kidney and a 10 cm central renal lesion. The consecutive computerized tomography (CT) revealed ruptured kidney due to a 10 cm central renal AML with bleeding in the tumour and a large perinephric hematoma around the right kidney (Figure 1). The hematoma was confined by Gerota's fascia and also a single precaval right renal artery was noticed (Figure 2).

Bottom Line: Spontaneous, nontraumatic retroperitoneal hemorrhage or Wunderlich syndrome (WS) is a rare but potential life-threatening condition.If angioembolization is not available open surgery is in most cases the preferred approach.We present a patient with a spontaneously ruptured kidney due to a central renal angiomyolipoma, which was treated by laparoscopic nephrectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University Clinics Salzburg, 5020 Salzburg, Austria.

ABSTRACT
Spontaneous, nontraumatic retroperitoneal hemorrhage or Wunderlich syndrome (WS) is a rare but potential life-threatening condition. In most patients a bleeding renal neoplasm is the cause of the retroperitoneal hematoma. The management of this condition includes a conservative approach in the hemodynamically stable patients and active treatment in the unstable patients. Active treatment includes angioembolization or surgery. If angioembolization is not available open surgery is in most cases the preferred approach. We present a patient with a spontaneously ruptured kidney due to a central renal angiomyolipoma, which was treated by laparoscopic nephrectomy.

No MeSH data available.


Related in: MedlinePlus