A rare case of spontaneous perirenal hemorrhage - Wunderlich syndrome

Abstract

Introduction. Spontaneous perirenal hemorrhage or Wunderlich syndrome represents a rare entity in the urological settings. The vast majority of the causes are represented by angiomyolipoma and renal cell carcinoma. In other cases, the vascular abnormalities, polycystic kidneys, polyarthritis nodosa or pyelonephritis could represent the cause of perirenal bleeding. The treatment depends on clinical parameters at the presentation as on the presence of eventual renal malignancies. Our goal was to present a rare case of a healthy men who presented the idiopathic Wunderlich syndrome. Case outline. We present the case of 50 years old patients with spontaneous perirenal hemorrhage which was not due to any defined cause even after sixth months follow-up. Conclusion. In some rare cases of perirenal bleeding the cause cannot be defined at the presentation, even with today?s very developed radiologic imaging and methods. Thus, it is important to be aware of the fact that in those cases, the longer follow up is needed, knowing that the presence of perirenal hematoma can always obscure the real diagnosis. Sometimes, even in the cases where the proper follow-up has been done, the real cause of the bleeding remains unknown.