Idiopathic Atraumatic Renal Hemorrhage: Case Report

TL;DR

This case report describes a rare condition called Wunderlich syndrome, where a 65-year-old man experienced sudden kidney bleeding without trauma and was successfully treated with conservative care.

Contribution

The paper adds a new clinical case of Wunderlich syndrome managed conservatively, highlighting its rarity and diagnostic challenges.

Findings

A 65-year-old male presented with spontaneous left renal hemorrhage confirmed by CT angiogram.

The patient was successfully managed with conservative treatment without surgical intervention.

Wunderlich syndrome is rare and often overlooked in differential diagnoses for flank pain.

Abstract

Wunderlich syndrome (WS) is a rare condition characterized by spontaneous, atraumatic renal hemorrhage. It often presents with non-specific symptoms and is typically diagnosed through computed tomography (CT). The most common presentation of WS includes the Lenk triad, which consists of flank pain, a palpable flank mass, and hypovolemic shock. If diagnosis and treatment are delayed, WS can rapidly progress and lead to unfavorable patient outcomes.

A 65-year-old male presented to the emergency department with severe sudden-onset left flank pain with subsequent CT angiogram demonstrating an actively bleeding left renal hematoma. The patient was managed conservatively with supportive care. His vitals remained stable, and he did not require any surgical or vascular interventions.

Wunderlich syndrome is a spontaneous renal or perinephric hemorrhage occurring in the absence of trauma; it is rarely included in the differential for patients with flank pain but can become life-threatening when not recognized.

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