Spontaneous subcapsular or perirenal haemorrhage caused by renal tumours. A urological emergency.
Scand J Urol Nephrol
; 33(1): 17-23, 1999 Feb.
Article
em En
| MEDLINE
| ID: mdl-10100358
ABSTRACT
OBJECTIVE:
Spontaneous perirenal haemorrhage is a rare abdominal emergency most commonly caused by solid renal tumours. The aim of this study was to evaluate the efficacy of different diagnostic methods and treatment modalities. MATERIAL ANDMETHODS:
A total of 9 patients (5 women and 4 men) with spontaneous subcapsular or perirenal haemorrhage caused by renal tumours were treated at two Finnish central hospitals over a period of 20 years. RESULTS ANDCONCLUSIONS:
All the patients presented with flank pain, often severe and associated with a palpable mass and a reduced haemoglobin concentration. Ultrasonography was abnormal in all cases where it was used, but was able to show the tumour and haemorrhage correctly in only one case (13%). Computed tomography had a sensitivity of 71%. Seven patients underwent extrafascial nephrectomy (5 renal cell cancers, 1 malignant oncocytoma and 1 angiomyolipoma) and two with known tuberous sclerosis and bilateral renal angiomyolipomas were treated by superselective embolization. As these few cases were all individual and were collected over a long period of time, general statements about diagnosis and treatment must be approached critically. It may be concluded, however, that spontaneous perirenal haemorrhage is often a surgical emergency necessitating great efforts in terms of diagnosis and treatment. Computed tomography should be performed on all patients nowadays. If the bleeding is caused by a malignant tumour, extrafascial nephrectomy is the treatment of choice. For those with benign tumours selective embolization should be used.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Angiomiolipoma
/
Adenoma Oxífilo
/
Adenocarcinoma de Células Claras
/
Hemorragia
/
Nefropatias
/
Neoplasias Renais
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Scand J Urol Nephrol
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
Finlândia