Spontaneous retroperitoneal haemorrhage of renal origin (Wunderlich syndrome): analysis of 8 cases.

ABSTRACT

OBJECTIVES: To analyze the characteristics, etiology and treatment of a series of patients with spontaneous retroperitoneal hemorrhage from renal causes. METHODS: We retrospectively reviewed patients diagnosed of spontaneous retroperitoneal hemorrhage between 2006 and 2011. All patients consulted for back pain and the diagnosis was made by computed tomography (CT) and /or magnetic resonance (MR). All patients were treated surgically. RESULTS: The series includes 8 patients. Six cases had renal mass and associated hematoma and 2 presented only perirenal hematoma. Six patients underwent total nephrectomy, one underwent partial nephrectomy, and one just drainage of the hematoma.The pathological study showed 4 cases of renal angiomyolipoma (one associated with multiple small renal carcinomas), 2 cases of renal carcinoma and 1 case of hemorrhagic renal infarction. CONCLUSION: Renal masses are the main cause of Wunderlich syndrome and CT is the diagnostic procedure of choice. Surgical treatment is preferred in patients with renal mass diagnosed and cases of hemodynamic compromise.