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2021, Number 6

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Rev Fac Med UNAM 2021; 64 (6)

Wünderlich Syndrome (Spontaneous Kidney Hemorrhage). Case Report

Segura GA, Barreda PA
Full text How to cite this article

Language: Spanish
References: 12
Page: 26-31
PDF size: 211.07 Kb.


Key words:

Hypovolemia, retroperitoneal hemorrhage, computed axial tomography, medical history, Lenk triad.

ABSTRACT

Background and objectives: Non-traumatic, spontaneous renal hemorrhage was first described in 1700 by Bonet, it was until 1856 that the physician Carl August Wünderlich made a complete clinical description and called it spontaneous apoplexy of the renal capsule. In 1910 Coenen reported a series of 13 cases and gave it the name Wünderlich syndrome. To date, about 300 cases have been reported in the medical literature. The objective of reporting a new case of Wünderlich syndrome is to share a relatively rare and underdiagnosed clinical entity with physicians.
Material and Method: The clinical case of an 88-year-old woman who was admitted to the emergency department with abdominal pain and hypovolemic shock is presented. A complete medical history was performed, and laboratory tests were taken, studies including chest radiography and simple and contrasted abdominal computed tomography were performed. She undergoes emergency surgery with the findings of a significant renal hemorrhage, nephrectomy is performed. Clinical and radiological data and histopathological findings are analyzed.
Results: Based on the surgical findings and the results of the histopathological study and finding no clinical history of trauma, but if the presence of a renal cyst where the spontaneous bleeding was caused the conclution is that it’s a Wunderlich syndrome.
Conclusions: Wunderlich syndrome or Spontaneous Renal Hemorrhage is a relatively rare clinical entity, characterized by sudden onset abdominal pain and clinical data of hypovolemia that every physician must know in order to establish a timely diagnosis and treatment.


REFERENCES

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  2. Pedemonte JG, De Giovanni D. Tríada de Lenk como presentación clínica del angiolipoma. Actas Urológicas Españolas. 2008:32(8):850-54.

  3. Pinilla R, López S. Síndrome de Wünderlich. Revista Colombiana de Cirugía. 2009;24:56-61.

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  8. Franco Carrillo D, Hernández López MA. Hemorragia renal no traumática. Síndrome de Wünderlich. Informe de un caso. Revista Mexicana de Urología. 2005; Vol:65 14:284-87.

  9. Brown ET, Perlmutter AE. Chromophobe renal cell carcinoma presenting as hemorrhagic shock. Canadian Journal of Urology. 2008;15:4276-8.

  10. Farzad Allameh, Saman Najafi. Chromophobe renal cell carcinoma presented with Wünderlich síndrome. International Journal of Cancer Management. 2017. In press.

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Rev Fac Med UNAM . 2021;64