Wunderlich Syndrome: A case report

Yıl 2019, Cilt: 36 Sayı: 3, 95 - 97, 10.02.2020

Ramazan Sami Aktaş Sevdegül Karadaş Veysel Eskin Gizem Gizli

Öz

Wunderlich syndrome is a rare cause of abdominal pain. This is spontaneous, nontraumatic kidney bleeding confined to the subcapsular and perirenal space. Various terms have been used including spontaneous perirenal haematoma, spontaneous subcapsular renal haemorrhage, nontraumatic perirenal haemato-ma and spontaneous perinephric haematoma. The etiology of spontaneous renal rupture has not been described yet. Possible causes include benign [e.g., an-giomyolipomas (AML), tuberous sclerosis, renal cyst, adenoma, lipoma, and hamartoma] and malignant (e.g., oncocytoma, renal clear cell carcinoma, and Wilms’ tumor) tumors or it can occur secondary to vasculitis (polyarteritis nodosa), nephritis, blood dyscrasias (anticoagulant agents, polycythaemia), renal stone disease, arteriovenous malformations and fistulas, venous thrombosis or rupture of renal artery/intraparenchymal aneurysm. Clinically this condition presents with acute flank pain, palpable flank mass and hypovolemic shock together known as ‘Lenk’s triad’. Historically, renal neoplasms followed by vascular diseases were the most common causes of Wunderlich syndrome. Our case was 50 years old woman. A spontaneous retroperitoneal hemorrhage patients who at night come to emergency with sudden abdominal pain. Wunderlich syndrome is cause of unexplained abdominal pain should be kept in mind.

Anahtar Kelimeler

emergency medicine, wunderlich syndrome, spontaneous retroperitoneal bleeding, nephrectomy

Kaynakça

• Baishya, R. K., Dhawan, D. R., Sabnis, R., & Desai, M. R. (2011). Spontaneous subcapsular renal hematoma: a case report and review of literature. Urology annals, 3(1), 44.
• Daskalopoulos, G., Karyotis, I., Heretis, I., Anezinis, P., Mavromanolakis, E., & Delakas, D. (2003). Spontaneous perirenal hemorrhage: a 10-year experience at our institution. International urology and nephrology, 36(1), 15-19.
• Flum, A. S., Hamoui, N., Said, M. A., Yang, X. J., Casalino, D. D., McGuire, B. B., . . . Nadler, R. B. (2016). Update on the diagnosis and management of renal angiomyolipoma. The Journal of urology, 195(4), 834-846.
• Katabathina, V. S., Katre, R., Prasad, S. R., Surabhi, V. R., Shanbhogue, A. K., & Sunnapwar, A. (2011). Wunderlich syndrome: cross-sectional imaging review. Journal of computer assisted tomography, 35(4), 425-433.
• Kendall, A. R., Senay, B. A., & Coll, M. E. (1988). Spontaneous subcapsular renal hematoma: diagnosis and management. The Journal of urology, 139(2), 246-249. Kim, J. W., Kim, J. Y., Ahn, S. T., Park, T. Y., Oh, M. M., Moon, D. G., & Park, H. S. (2018). Spontaneous perirenal hemorrhage (Wunderlich syndrome): An analysis of 28 cases. The American journal of emergency medicine.
• Murphy, G. S., Sparks, S. E., Goldberg, S. R., & Morton, J. R. (2013). Spontaneous retroperitoneal hemorrhage in a dialysis patient. The Journal of emergency medicine, 44(2), e217-e219.
• Vaddi, S. P., Reddy, V. P., & Devraj, R. (2011). Wunderlich's syndrome in a tuberous sclerosis patient. Indian Journal of Surgery, 73(3), 227-229.
• Virchow, R. (1856). Handbuch der speciellen Pathologie und Therapie (Vol. 6): Enke.
• Zhang, J. Q., Fielding, J. R., & Zou, K. H. (2002). Etiology of spontaneous perirenal hemorrhage: a meta-analysis. The Journal of urology, 167(4), 1593-1596.