Wunderlich Syndrome Associated With Angiomyolipomas
- PMID: 35530872
- PMCID: PMC9072293
- DOI: 10.7759/cureus.23861
Wunderlich Syndrome Associated With Angiomyolipomas
Abstract
Wünderlich syndrome (WS) is a spontaneous retroperitoneal hemorrhage confined to the subcapsular or perinephric space without a history of trauma. Since it is a rare condition with a significant mortality rate if not treated timely, it is essential to identify its risk factors and early clinical manifestations for a favorable outcome. Various conditions are associated, but the most common causes are benign and malignant renal neoplasms. We present a 26-year-old female with a history of tonic-clonic seizures who presented to the ED with intense abdominal pain located on the right flank with a palpable mass. Management included IV fluids and blood transfusion. She underwent a right total nephrectomy. She was later diagnosed with tuberous sclerosis. A 44-year-old female with a three-year history of right costovertebral pain and recurrent urinary tract infections that presented to the ED with acute right flank pain was diagnosed with WS secondary to an angiomyolipoma and underwent right total nephrectomy. WS is a very rare pathology that represents a diagnostic challenge for the physician. The treatment will depend on the hemodynamic condition of the patient. Active follow-up should be reserved for those who have small tumors, are asymptomatic, and have hemodynamic stability. Surgical or radiology intervention is reserved for those who are hemodynamically unstable or who have a suspicion of renal cell carcinoma.
Keywords: flank pain; herlyn-werner-wunderlich syndrome; lenk's triad; perirenal hematoma; renal angiomyolipoma.
Copyright © 2022, Ramirez-Limon et al.
Conflict of interest statement
The authors have declared that no competing interests exist.
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References
-
- Wunderlich syndrome. Chen YC, Lin YC. QJM. 2013;106:187–188. - PubMed
-
- Wunderlich syndrome, spontaneous ruptured renal angiomyolipoma and tuberous sclerosis. Ho TH, Yang FC, Cheng KC, Lin CC, Lee JT. QJM. 2019;112:283–284. - PubMed
-
- Wunderlich syndrome: cross-sectional imaging review. Katabathina VS, Katre R, Prasad SR, Surabhi VR, Shanbhogue AK, Sunnapwar A. J Comput Assist Tomogr. 2011;35:425–433. - PubMed
-
- Spontaneous perirenal hemorrhage (Wunderlich syndrome): an analysis of 28 cases. Kim JW, Jung YK, Ahn ST, et al. Am J Emerg Med. 2019;37:45–47. - PubMed
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