CT evaluation of underlying cause in spontaneous subcapsular and perirenal hemorrhage

Abstract

We evaluated the CT scans of 13 patients with spontaneous subcapsular or perinephric hemorrhage (SPH) associated with these underlying causes: 4 angiomyolipomas, 2 renal cell carcinomas, 1 renal metastatic malignant melanoma, 1 ruptured renal artery aneurysm, 1 adrenal myelolipoma, 1 ruptured renal abscess, 2 ruptured hemorrhagic cysts, and 1 patient with undiagnosed coagulation disorder. Our objective was to ascertain whether an underlying cause of SPH was identifiable by CT, and to determine the extension of the hematomas. Computed tomography identified the hematoma in all 13 cases (sensitivity 100 %). In all 12 cases in which there was a renal or adrenal anatomic lesion, the underlying cause was identified with CT (100 %), with correct diagnosis in 11 cases (91.6 %). The case in which no lesion was identified was the undiagnosed coagulation disorder. We conclude that CT is a useful technique for the initial evaluation of SPH, permitting diagnosis of hemorrhage and identification of the underlying cause.

Comparative Evaluation of Ultrasonography and Computed Tomography Findings in Renal Masses.

“…1 case was diagnosed as hematoma on USG but when CT was done this lesion contains fat and was found to be AML associated with hemorrhage. Our study correlates with study of Sebastia et al [40] (1997) who concluded that CT is a useful technique for the initial evaluation of SPH permitting diagnosis of hemorrhage and identification of the underlying cause.…”

Chromophobe Renal Cell Carcinoma Presented with Wunderlich Syndrome

“…The most reliable modality in diagnosing retroperitoneal hemorrhage and RCC is contrast enhanced CT Scan (CECT) (7). However, the reliability of CT scan in diagnosing RCC at the time of bleeding is an area of controversy (8).…”

Case report: Delayed spontaneous retroperitoneal haematoma after unilateral total hip replacement

“…A contrast-enhanced CT scan is regarded as the most sensitive diagnostic modality in revealing the bleeding site and identifying any underlying pathology [26]. Ultrasonography is less sensitive than CT in detecting renal pathology but may be used as an alternative for following up conservatively-treated retroperitoneal haematomas, as it is a rapid, easily available, cost-effective and radiation-free modality.…”