A Case of Spontaneous Renal Haemorrhage (Wunderlich Syndrome) in an Anticoagulated Patient

  • Manuela Giovini Intermediate Care Unit, Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Erika Poggiali Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Piervito Zocchi Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Esterina Bianchi Radiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Elio Antonucci Intermediate Care Unit, Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Mario Barbera Intermediate Care Unit, Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
DOI: https://doi.org/10.12890/2022_003269

Keywords

Spontaneous renal haemorrhage, renal haematoma, Wunderlich syndrome, anticoagulation, flank pain, contrast-enhanced computed tomography

Abstract

Spontaneous renal haemorrhage is a rare but severe condition known as Wunderlich syndrome (WS). The classic presentation includes sudden-onset flank pain, a palpable flank mass and hypovolaemic shock (Lenk’s triad). WS can be due to neoplasms, vascular diseases, cystic rupture, coagulopathies and infections. A contrast-enhanced CT scan of the abdomen is mandatory for diagnosis. Surgery is reserved for haemodynamically unstable patients and those with neoplastic disease. We describe a case of WS in an anticoagulated patient with chronic atrial fibrillation, diabetes mellitus type 2 and hypertension, who developed acute renal failure and severe anaemia, that completely resolved with conservative treatment and discontinuation of anticoagulation therapy.

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    • Published: 2022-04-01

    Issue: 2022: Vol 9 No 4 (view)

    Section: Articles

    How to cite:
    1.
    Giovini M, Poggiali E, Zocchi P, Bianchi E, Antonucci E, Barbera M. A Case of Spontaneous Renal Haemorrhage (Wunderlich Syndrome) in an Anticoagulated Patient. EJCRIM 2022;9 doi:10.12890/2022_003269.

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