Subcapsular hematoma as a complication of acute pyelonephritis: a case report

Abstract

A case of subcapsular hematoma, a rare complication of acute pyelonephritis (APN) is described. A 60-year-old diabetic woman was admitted with a 3 day history of fever and left flank pain due to acute pyelonephritis. On the third day in hospital, left flank pain worsened despite use of antibiotics available for the treatments of APN and hemoglobin rapidly decreased from 11.1 to 7.9 g/dL. Ultrasonography and abdominal CT showed left subcapsular hematoma. Renal angiography demonstrated an ovoid avascular zone between the capsular artery and parenchyme of the left kidney with no evidence of tumors or vascular abnormalities, such as arteriovenous malformation or fistula. Subsequent percutaneous drainage of this subcapsular hematoma was performed and showed old blood-colored drainage. Hereby, the possibility of subcapsular renal hematoma in the course of acute pyelonephritis is stressed as a rare complication.

Spontaneous Subcapsular Renal Hematoma as a Complication of Acute Pyelonephritis: A Case Report

“…This attitude is confirmed by the authors, which refer APN as a cause of SSRH (3)(4)(5). In the presented case we highlight the importance of timely and adequate diagnostic approach (US, MDCT), and then, in accordance with the diagnosis of the underlying cause, the implementation of appropriate antibiotic therapy (according to the antibiogram), as well as percutaneous drainage of SSRH.…”

“…It generally occurs as a result of other pathological conditions, like tumors, vascular diseases, extremely rare as a result of infection, or other causes, including the state of an unknown etiology (1,2). Very rarely SSRH may occur as a complication of APN, and in the available literature, we found only three such cases (3)(4)(5). In the clinical picture dominates general symptomatology (fatigue, pain, fever), and a decrease in hemoglobin (6).…”

Subcapsular Renal Hematoma Complicating Acute Pyelonephritis

“…In addition, as an extremely rare complication of APN, renal hematoma also has been reported, predominately in patients with emphysematous pyelonephritis (3,5). We were able to find only one previous report of a similar case in the literature; however, percutaneous drainage of the subcapsular hematoma was performed for treatment (6).…”

Perinephric Capsular Haematoma Associated with Complicated Pyelonephritis in a Patient with HIV

“…Infection has only rarely been reported in association with a perinephric haematoma (2). We report a case in a patient with an unknown diagnosis of HIV who presented with a spontaneous haematoma due to severe complicated pyelonephritis.…”