# 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.

## Key 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.