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.