Rodríguez PR, Agüero GJL, Cerdeiras MGR

Language: Spanish
References: 0
Page: 121-126
PDF size: 200.63 Kb.

ABSTRACT

Introduction: Retroperitoneal blood leakage spontaneously is an infrequent condition in daily urological practice. Renal origin was described by Wünderlich who described it as "a spontaneous apoplexy of the renal capsule". Objective: To present a case of Wünderlich syndrome describing its clinical picture as well as the diagnostic means used for diagnosis and possible therapeutic options. Case presentation: Female patient, 51 years old, Caucasian, with a history of systemic lupus erythematosus and chronic renal failure. After the end of a hemodialysis session, she began abruptly with severe pain in the left lumbar fossa accompanied by nausea, vomiting and profuse sweating, physical examination shows tachycardia, mucosal cutaneous pallor and decrease of the peripheral pulses, besides palpable renal mass with bulging in the fossa Left lumbar. Performing ultrasound describes a large perirenal collection that moves the left kidney up. Results: The patient underwent emergency surgery and, when approaching the lumbar fossa, we observed a large perirenal hematoma due to rupture of the inferior pole of the left kidney. Left nephrectomy was performed. Conclusions: The initial ability will be directed to the evaluation of the hemodynamic state and to try to correct the deficit of blood volume, then a detailed study that will include diagnostic ultrasound and computed tomography to corroborate the diagnosis should be carried out. Conservative treatment can be applied with blood volume correction or if there is a hemodynamic compromise, emergency nephrectomy is indicated by a laparotomy incision or laparoscopic nephrectomy.