Laparoscopic Treatment of a Spontaneously Ruptured Kidney (Wunderlich Syndrome)

Bretterbauer, Katharina Maria; Markić, Dean; Colleselli, Daniela; Hruby, Stephan; Magdy, Ahmed; Janetschek, Günter; Mitterberger, Michael

doi:10.1155/2015/701046

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…6 Desde a primeira embolização de um angiomiolipoma renal em 1976 por Moorhead et al, a embolização selectiva dos AML com hemorragia tornou-se o tratamento recomendado, sendo seguro, e ciente e poupador de nefrónios. 1,2,4,6,7 Quando a intervenção não é possível ou não alcança o resultado pretendido a nefrectomia (parcial ou total) é recomendada. A abordagem cirúrgica do hematoma pode agravar a hemorragia.…”

Section: Discussionunclassified

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Síndrome de Wunderlich, uma causa rara de dor abdominal

Oliveira¹,

Torres-Ramalho²,

Lopes³

2017

Gal. Clin.

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RESUMOA síndrome de Wunderlich é uma doença rara que se caracteriza por hemorragia espontânea nos espaços subcapsular e perirrenal. Apresentamos dois casos de síndrome de Wunderlich. Uma mulher de 38 anos com esclerose tuberosa que se apresentou com dor abdominal e hipotensão. A tomogra a computadorizada (TC) revelou um hematoma peri-renal. Uma mulher de 86 anos, anticoagulada com varfarina por tromboembolismo pulmonar, apresentou-se com dor abdominal nos quadrantes inferiores. A TC abdominal revelou uma massa renal com hemorragia no espaço peri--renal. Foram ambas submetidas a embolização super-seletiva da artéria renal, com boa evolução posterior. Palabras clave: síndrome de wunderlich, angiomiolipoma, femorragia renal espontánea ABSTRACTWunderlich syndrome is a rare disease characterized by spontaneous renal hemorrhage into the subcapsular and perirenal spaces. We report two cases of Wunderlich syndrome. A 38-year-old woman with tuberous sclerosis presented with abdominal pain and hypotension, perinephric hematoma was diagnosed by computerized tomography (CT) scan. A 86-year-old woman, treated with warfarin for pulmonary embolism, presented with abdominal pain in the lower quadrants. Abdominal CT scan revealed a renal mass with recent hemorrhage to perinephric space. Renal artery highly selective embolization was performed with good outcome in both cases.

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Section: Discussionunclassified

“…A abordagem cirúrgica do hematoma pode agravar a hemorragia. 6,7 A abordagem por cirurgia aberta convencional é a mais frequente, sendo também possível a abordagem minimamente invasiva por laparoscopia. 7 Na embolização seletiva dos ramos da artéria renal em doentes com AML a taxa de sucesso varia entre 80 e 90%.…”

Section: Discussionunclassified

Síndrome de Wunderlich, uma causa rara de dor abdominal

Oliveira¹,

Torres-Ramalho²,

Lopes³

2017

Gal. Clin.

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Primary robot-assisted laparoscopic partial nephrectomy for hemorrhage secondary to angiomyolipoma: a retrospective study from a large tertiary hospital in China

Hua,

Chen,

Zhang

et al. 2024

Sci Rep

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With the continuous development of robot-assisted technology, Robot-assisted Laparoscopic Partial Nephrectomy (RALPN) has gradually become an optional method for the treatment of Hemorrhage secondary to angiomyolipoma (HSA). However, there are rare clinical reports of the primary RALPN for HSA. Therefore, this research aims to evaluate the efficacy and safety of primary RALPN for HSA. Fourteen patients(six males and eight females), aged 14–56 years, underwent primary RALPN for HSA and were retrospectively analyzed from 2015 to 2023. The initial blood routine examination revealed decreased hemoglobin in all patients, and Contrast-enhanced computed tomography (CT) indicated retroperitoneal hematoma. After correcting shock and electrolyte imbalance through fluid therapy and medical treatment, all primary RALPN procedures were performed with transabdominal access on the side of the Hemorrhage. After tumor resection and hematoma removal with a monopolar Curved Scissor, the absorbable barbed suture was performed for inner and outer running stitches, respectively. Patient demographic information, perioperative characteristics, and functional outcomes were collected and analyzed. The initial tumor size of fourteen patients ranged from 57 to 145 mm, and the RENAL ranged from 7 to 11. All of the HSA was controlled, and primary RALPN was successful. The operating time it was ranged from 105 to 265 min. Postoperatively, one patient exhibited chylous drainage (Clavien-Dindo II), and another patient developed pleural effusion (Clavien-Dindo III). No postoperative transfusion and Digital Subtraction Angiography (DSA) highly selective embolization of the bleeding vessel was needed. No patients developed urinoma or urinary fistula. Within the follow-up period, the overall complications were manageable. Primary RALPN is a safe and effective procedure for HSA, which may be considered an alternative to selective renal artery embolization.

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Laparoscopic Treatment of a Spontaneously Ruptured Kidney (Wunderlich Syndrome)

Cited by 2 publications

References 8 publications

Síndrome de Wunderlich, uma causa rara de dor abdominal

Síndrome de Wunderlich, uma causa rara de dor abdominal

Primary robot-assisted laparoscopic partial nephrectomy for hemorrhage secondary to angiomyolipoma: a retrospective study from a large tertiary hospital in China

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