Spontaneous perinephric and subcapsular renal hemorrhage: evaluation with CT, US, and angiography.

Abstract

Eighteen consecutive patients with acute spontaneous perinephric hemorrhage were examined with computed tomography (CT) (n = 18), ultrasonography (US) (n = 15), and angiography (n = 9). Renal cell carcinoma was found in 10 patients; angiomyolipoma, three; and segmental renal infarction, arteriovenous malformation (AVM), hemorrhagic cyst, abscess, and idiopathic hemorrhage, one each. Initial CT examinations demonstrated the extent of hemorrhage in all cases and a distinct mass in 12 (67%), with CT characteristics suggestive of the correct diagnosis in 11. In the other six patients (33%), a discrete mass was not seen at initial CT, and in five cause of hemorrhage was not clear. Two of the five underwent follow-up CT, which correctly demonstrated carcinoma in both. Overall, CT findings suggested the correct diagnosis in 14 patients (78%). US was sensitive for detection of an abnormality but nonspecific as to its nature. Angiography demonstrated unsuspected AVM in one patient, segmental renal infarction seen at CT in one, but only one of five carcinomas suspected at CT. Data from this study suggest that CT is the most valuable examination for patients with spontaneous renal hemorrhage.

Sudden onset of a huge subcapsular renal hematoma following minimally invasive ureteroscopic holmium laser lithotripsy: A case report

“…In general, contrast-enhanced CT scans were required for a confirmed diagnosis, in which the extent of the renal injuries and the diameter of the hematoma were assessed accurately, and the presence of active bleeding was determined. On an enhanced CT scan, an irregular, heterogeneous area around the kidney, with an attenuation value less than that of the artery or renal parenchyma, is known to indicate a SRH without active bleeding (8). In the present case, CT imaging was undertaken to clarify the diagnosis of an acute abdomen as quickly as possible, since a similar case had not been experienced previously, and the bleeding was controlled under a conservative management regimen.…”

Spontaneous Rupture of Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report

“…Regarding the mechanisms of RCC rupture, several theories have been proposed, including congestion of renal veins due to obstruction by the RCC, vascular extension and tearing by rapid enlargement of the RCC, and direct invasion of the RCC into the renal vasculature [8]. Enhanced CT is most effective for detection of spontaneous rupture of RCC, but the detection rate of the tumor is only about 60% and it is more difficult to identify the tumor at the acute stage of the rupture [9]. Angiography in a case of RCC shows an avascular area, pooling of contrast agent, and an arteriovenous fistula, but it is also difficult to identify the tumor due to compression by hematoma in a case of tumor rupture.…”

Nasopalatine Cyst: A Silent Growing Lesion

“…Clinically, can be shown as clear visible ridges beside the incisive papilla even as a fistula that extends itself from the mouth to the nasal cavity. Through the catheterization maneuver of the persistent and total or part latent nasopalatine duct, with gutta-percha cone and periapical radiography, it allows the visualization of the lumen passage [9][10]. Besides, it can cause displacement and adjacent structures, expansion of the cortical vestibular bone and palatine, swelling of the incisive foramen and upper displacement of the nasal cavity floor [2,6,11].…”