Spontaneous Perirenal Hematoma

Gupta, Narmada P.; Karan, S.C.; Aron, Monish; Pawar, Ratnesh; Ansari, M. Sib

doi:10.1159/000030533

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…Transfusion should be immediately started in cases in which signs of hypovolemic shock are observed or where the hemoglobin level is severely decreased (our cases 3, 6). In order to prevent kidney function impairment and potential secondary hypertension, percutaneous drainage was offered when deemed necessary owing to progression of symptoms, large or infective hemorrhage, and shortened the time to resolution (our case 3, 5, 8) [7,11,12]. All patients responded well to our treatment, and CT showed complete absorption of the RSH at 6 months' follow-up.…”

Section: Discussionmentioning

confidence: 94%

Renal Subcapsular Hemorrhage Complicating Ureterolithotripsy: An Unknown Complication of a Known Day-to-Day Procedure

Meng

Chen

et al. 2013

Urol Int

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Objective: To report the incidence, risk factors, and treatments of renal subcapsular hemorrhage (RSH) complicating ureteroscopic lithotripsy (URSL). Patients and Methods: Data from 1,918 URSLs performed between January 2004 and March 2012 were retrospectively analyzed. Patients' data included age, sex, relevant medical history, stone side, size, and degree of hydronephrosis. Results: All 8 patients were identified as having an RSH after URSL. There were 2 males and 6 females with a mean age of 45.6 years (range 30-62 years). The patients' relevant medical histories (renal calculi extracorporeal shock wave lithotripsy, renal operation and hypertension) were statistically different between those who did and did not develop an RSH. Acute onset of flank pain is the most common symptom. Three patients with infective and large hemorrhage were managed by percutaneous nephrostomy in 1 and percutaneous subcapsular drainage in 2. Five patients with small and uninfected hemorrhage were managed conservatively. Conclusions: The rate of development of RSH complicating URSL is very low. RSH complicating URSL can occur in patients with underlying renal abnormalities. RSH is rarely associated with abrupt hemodynamic instability and usually not lethal. Treatment is selected based on the patient's hemodynamic state, infection, renal function, and the feasibility of treatment modality.

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Section: Discussionmentioning

confidence: 94%

Renal Subcapsular Hemorrhage Complicating Ureterolithotripsy: An Unknown Complication of a Known Day-to-Day Procedure

Meng

Chen

et al. 2013

Urol Int

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“…If the daily drainage volume is above 500 mL and lasting for more than 2 weeks with no obvious symptom relief, or if the volume of renal subcapsular fluid remains with no obvious reduction or accumulated again identified by ultrasonography, then those patients should be recommended to receive open or laparoscopic renal capsulectomy, as performed in our cohort of the patients. 16 The key points for this surgery are to remove the renal capsula of the diseased area as much as possible and to eliminate the secretory capacity of the renal capsula. 17 The possible mechanism for this successful surgery is to stop the continuous fluid collection by increasing the pressure between the kidney and perirenal fat and fascia; the fluid might be directly absorbed by the perirenal and retroperitoneal fat tissues after the surgery.…”

Section: Disscussionmentioning

confidence: 99%

The Retroperitoneal Laparoscopic Renal Capsulectomy for Spontaneous Renal Subcapsular Fluid Collection

Zhu

Wu²,

Wu³

et al. 2016

Medicine

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Spontaneous renal subcapsular fluid collection may occur as a rare presentation of nephritic syndrome, and distension of the renal capsula and Gerota fascia due to massive fluid accumulation may cause pain. In addition, hypertension secondary to renal ischemia and activation of renin–angiotensin–aldosterone system may also occur. The objective of this study is to evaluate the surgical outcome of retroperitoneal laparoscopic renal capsulectomy for patients with this disease.We retrospectively analyzed the clinical data of 10 female patients with spontaneous renal subcapsular fluid collection, diagnosed with B ultrasound and enhanced computed tomography (CT) scan. Eight patients first underwent percutaneous renal subcapsular drainage, which seemed to be less effective, and then all patients underwent retroperitoneal laparoscopic renal capsulectomy. The volume of renal subcapsular fluid was documented, the fluid was examined by routine biochemical tests, and the excised renal capsules underwent pathological examination individually. The postoperative drainage time for each patient was documented, and follow-up was conducted 1, 3, 6, 12 months, and 2 years postoperatively.Retroperitoneal laparoscopic renal capsulectomy was successfully performed in all patients with no major complications. The average volume of renal subcapsular fluid was 436 milliliter (mL, 180–880 mL) in light yellow color, and the concentration of creatinine and urea nitrogen was quite similar to that of serum. The pathological findings revealed fibrous dysplasia of the renal capsule with chronic infiltration of inflammatory cells. The average drainage time was 11.5 days (5–30 days) postoperatively. All patients recovered 1 month after the operation and there were no recurrences with a mean follow-up period of 12 months (6–24 months).The reason for spontaneous renal subcapsular fluid collection is unknown, and the aim of treatment is mainly to alleviate symptoms. In our experience, retroperitoneal laparoscopic renal capsulectomy is an effective surgical treatment, especially for patients who were refractory to percutaneous renal subcapsular drainage, with no observed recurrence.

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Prolonged fever following kidney biopsy: a case report

et al. 2008

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This case report describes a patient with prolonged fever following a kidney biopsy. Workup disclosed a large perirenal and retroperitoneal hematoma. Neither imaging nor blood cultures supported an infective cause of his fever. Although the patient was initially treated with antibiotics, fever eventually resolved spontaneously. A review of the literature is provided addressing the association of fever with resorption of hematoma. Fever should be added to the list of potential complications of kidney biopsy. A conservative management is advocated.

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Spontaneous Perirenal Hematoma

Cited by 7 publications

References 16 publications

Renal Subcapsular Hemorrhage Complicating Ureterolithotripsy: An Unknown Complication of a Known Day-to-Day Procedure

Renal Subcapsular Hemorrhage Complicating Ureterolithotripsy: An Unknown Complication of a Known Day-to-Day Procedure

The Retroperitoneal Laparoscopic Renal Capsulectomy for Spontaneous Renal Subcapsular Fluid Collection

Prolonged fever following kidney biopsy: a case report

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