SHM Converge Scientific Abstract ePoster Gallery-All That Bleeds Does Not Need Surgery a Rare Case of Spontaneous Perinephric Hematoma Wunderlichs Syndrome

All That Bleeds Does Not Need Surgery a Rare Case of Spontaneous Perinephric Hematoma Wunderlichs Syndrome

Pdf Summary

This case report describes a woman who presented with a spontaneous left perinephric hematoma, also known as Wunderlich’s syndrome. CT abdomen/pelvis with contrast showed a left perinephric hematoma. During hospitalization, her hemoglobin dropped to 8.1 g/dL, raising concern for active bleeding. She underwent aortography with left renal arteriography, which showed no extravasation and no vascular malformation.<br /><br />Additional evaluation found elevated inflammatory markers, including ESR 60 and CRP 2.5, but a vasculitis workup was negative, with normal ANA, ANCA panel, and complement levels. Because she remained hemodynamically stable and no ongoing bleeding was seen on angiography, she was managed conservatively with intravenous fluids and opioid analgesics rather than surgery or intervention.<br /><br />Follow-up imaging six months later showed complete resolution of the hematoma. The report highlights that not all spontaneous perinephric hemorrhages require surgical treatment. In stable patients without evidence of active hemorrhage or a structural vascular cause, conservative management can be successful.

Asset Subtitle

Syed R. Shah

Meta Tag

Author List Benton Huang, Maninderjit Singh, Sobia Syed, Syed R. Shah

Category Clinical Vignettes

Concept Spontaneous Perinephric Hematoma

Concept Active Bleeding

Concept Flank Pain

Concept Hemoglobin Drop

Concept Computed Tomography

Distinguished Non-Finalist

Presenter Organization University of Washington

Presenting Author Syed R. Shah

Track Adult

Keywords

Wunderlich syndrome

spontaneous perinephric hematoma

left renal hemorrhage

CT abdomen pelvis

renal arteriography

hemoglobin drop

vasculitis workup

conservative management

intravenous fluids

follow-up imaging

Spontaneous Perinephric Hematoma

Active Bleeding

Flank Pain

Hemoglobin Drop

Computed Tomography