A Case of Spontaneous Atraumatic Renal Bleeding (Wunderlich Syndrome)

TL;DR

A 72-year-old woman with atrial fibrillation experienced a rare spontaneous kidney bleed, which was successfully treated with embolization.

Contribution

This case highlights the rare occurrence and effective management of Wunderlich Syndrome in a patient on anticoagulant therapy.

Findings

The patient presented with symptoms of sudden left abdominal pain and dizziness due to a renal bleed.

Imaging confirmed an active renal arterial bleed, leading to successful embolization of pseudoaneurysms.

Conservative management failed, necessitating interventional treatment for ongoing bleeding.

Abstract

We present an uncommon case of atraumatic spontaneous renal hemorrhage in a 72-year-old woman with a background of atrial fibrillation on edoxaban who presented with a sudden onset of left abdominal pain, nausea, vomiting, lethargy, and dizziness. Cross-sectional imaging was performed and confirmed an ongoing renal bleed. She had a trial of conservative management; however, repeated imaging showed an ongoing, slow but active renal arterial bleed; hence, she underwent an embolization procedure. On-table angiogram revealed pseudoaneurysms in the upper and lower poles of the kidney, for which she underwent successful renal artery embolization.

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