A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)

Anastasiou, Ioannis; Katafigiotis, Ioannis; Pournaras, Christos; Fragkiadis, Evangelos; Leotsakos, Ioannis; Mitropoulos, Dionysios; Constantinides, Constantinos

doi:10.1155/2013/452317

Cited by 5 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Renal artery aneurysm (RAA) is uncommon. It affects 1 in 10000 inhabitants and accounts for 22% of all visceral artery aneurysms [ 1 , 2 ]. In most cases, it is recognized incidentally without any clinical signs [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic hilar renal artery aneurysm mimicking renal colic - a word of caution

2018

Cent european J Uro

View full text Add to dashboard Cite

An adequate and timely diagnosis is crucial in the treatment of renal artery aneurysms during pregnancy since the risk of rupture and its catastrophic consequences are high. Clinical symptoms, laboratory results, and B-mode abdominal ultrasonography may mimic renal colic. In this report, a case of a pregnant 26-year-old woman with a large, symptomatic renal aneurysm is presented. The diagnostic pathway and the treatment are described. Potential pitfalls in the diagnosis are discussed.

show abstract

Section: Discussionmentioning

confidence: 99%

Symptomatic hilar renal artery aneurysm mimicking renal colic - a word of caution

2018

Cent european J Uro

View full text Add to dashboard Cite

show abstract

“…Regarding patients with hypertension, the frequency of the RAA rises to 2.5% and when the hypertension is unresponsive to medical therapy, it can be as high as 39%. In less than 10% of the patients with RAA, the lesion may be located inside the renal parenchyma [ 1 , 2 ]. In general, there are four types of RAAs: the saccular, fusiform, dissecting, and the arteriovenous/microaneurysm (intrarenal) with the saccular being the most frequent one as it accounts for about 70% of all RAAs.…”

Section: Discussionmentioning

confidence: 99%

“…In general, there are four types of RAAs: the saccular, fusiform, dissecting, and the arteriovenous/microaneurysm (intrarenal) with the saccular being the most frequent one as it accounts for about 70% of all RAAs. Risk factors for the development of an RAA include renal congenital malformations, untreated hypertension, atherosclerosis, trauma, pregnancy, recent surgery, malignancy, angiomyolipoma of the kidney, radiation exposure, and use of drugs like cyclophosphamide [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…It can be discovered incidentally during workup for hypertension or during abdominal imaging for an unrelated reason (i.e., KUB radiography or ultrasonography) [ 1 ]. RAA accounts for 22% of visceral aneurysms [ 2 ]. Due to its potential complications, it should be given due consideration with complete imaging, follow-up (MDCT, MRA, and angiography), and treatment when indicated [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Imaging of a Renal Artery Aneurysm Detected Incidentally on Ultrasonography

Rafailidis

Gavriilidou

Liouliakis

et al. 2014

Case Reports in Radiology

View full text Add to dashboard Cite

Renal artery aneurysms occur with a frequency of less than 1% of the general population. Even if they are usually asymptomatic and incidentally found, they can be complicated with life-threatening conditions like rupture, thrombosis, embolism, or hypertension. Thus, once diagnosed, they should be fully evaluated with further imaging and treated when indicated. We present the case of a patient who was referred for ultrasonography for an unrelated reason. The examination demonstrated a hyperechoic focus near the right kidney. Further imaging workup with MDCT established the diagnosis of a right renal artery aneurysm which was saccular in shape and peripherally calcified. This ring-like calcification was also visible in a KUB radiography which was also performed. After presenting the case, various aspects of this rare entity are discussed.

show abstract

“…Wunderlich's syndrome is a spontaneous non-traumatic bleeding confined to the subcapsular and/or perinephric spaces in patients with no known underlying cause and constitutes an emergency medical condition (1,2). Various terms have been used including spontaneous perirenal haematoma, spontaneous subcapsular renal haemorrhage, nontraumatic perirenal haematoma and spontaneous perinephric haematoma.…”

Section: Introductionmentioning

confidence: 99%

Cough-Induced Spontaneous Rupture of the Kidney Secondary to Anticoagulant Therapy: Wunderlich’s Syndrome

Narter¹,

Sabuncu²,

Eryıldırım³

et al. 2017

jus

View full text Add to dashboard Cite

Spontaneous renal or other organ ruptures secondary to anticoagulants have rarely been reported. The clinical features of renal rupture include acute flank/abdominal pain, haematuria, hypotension and shock. It can occur due to increased intraabdominal pressure during coughing. Rupture is most commonly caused by renal tumors such as angiomyolipomas. In the literature, other known causes are long-term haemodialysis, arteriosclerosis or arteritis. Wunderlich's syndrome is an extremely dangerous complication that may cause death if not treated intensively. If the haemorrhage is self-limiting and the patient is responsive to fluid replacement, the patient can be managed conservatively. Selective angiographic embolization and emergency nephrectomy (partial or total) are the treatment options. In the literature, we found only one case that was presented as spontaneous non-traumatic renal rupture associated with coughing. In our case, total nephrectomy had to be performed, but it was not adequate. Keywords: Spontaneous renal rupture, cough, anticoagulant, Wunderlich's syndrome Spontan böbrek veya diğer organ rüptürleri antikoagülanlara sekonder çok nadir bildirilmiştir. Klinik tabloda akut flank/karın ağrısı, hematüri, hipotansiyon ve şok görülebilir. Öksürük esnasında karın içi basıncının artışına bağlı oluşabilir. Rüptürün en sık sebebi anjiomyolipomlar gibi böbrek tümörleridir. Diğer sebepler arasında uzun süreli diyaliz, arteritler ve ateroskleroz sayılabilir. Eğer agresif tedavi edilmezse hayatı tehdit eden bir durumdur. Hemoraji kendini sınırlarsa konservatif yaklaşılabilir. Anjiyografik selektif embolizasyon ve parsiyel/total nefrektomi diğer tedavi seçenekleridir. Literatürde buna benzer bir olgu bildirilmiştir. Bizim olgumuzda takip sonrası total nefrektomi yapılsa da, bu yeterli olmamıştır.

show abstract

A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)

Cited by 5 publications

References 12 publications

Symptomatic hilar renal artery aneurysm mimicking renal colic - a word of caution

Symptomatic hilar renal artery aneurysm mimicking renal colic - a word of caution

Imaging of a Renal Artery Aneurysm Detected Incidentally on Ultrasonography

Cough-Induced Spontaneous Rupture of the Kidney Secondary to Anticoagulant Therapy: Wunderlich’s Syndrome

Contact Info

Product

Resources

About