# Bilateral renal hemorrhage in an anticoagulated patient: A rare case of Wunderlich syndrome

## TL;DR

An elderly patient on blood thinners experienced rare bilateral kidney bleeding, known as Wunderlich syndrome, requiring urgent care.

## Contribution

This case report highlights a rare manifestation of Wunderlich syndrome with bilateral renal hemorrhage in an anticoagulated patient.

## Key findings

- Bilateral renal hemorrhage was diagnosed via contrast-enhanced CT in an 84-year-old woman.
- The patient presented with hypovolemic shock and acute bilateral flank pain.
- Multidisciplinary management was required due to anticoagulant therapy.

## Abstract

We describe a rare case of Wunderlich syndrome with bilateral renal hemorrhage in a patient under anticoagulant therapy for atrial fibrillation. An 84-year-old woman came to our department complaining of acute bilateral flank pain. Clinical and laboratory examinations revealed a condition of hypovolemic shock. An abdominal contrast-enhanced CT scan detected the presence of a bilateral hemorrhage affecting the peri- and para-renal spaces. Planning an appropriate management strategy considering the anticoagulated treatment required a multidisciplinary approach in the case of the Wunderlich syndrome diagnosis.