Spontaneous Rupture of Renal Tumours Presenting as Surgical Emergency

Chan, Kin Wai; Chan, Kwok–Wah

doi:10.1111/j.1464-410x.1993.tb15937.x

Cited by 17 publications

(4 citation statements)

References 10 publications

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“…This case, where the patient is afflicted by Wunderlich syndrome and type 1 diabetes mellitus, prompts contemplation of various clinical and therapeutic considerations. The confluence of both conditions underscores the intricacies inherent in managing this infrequent pathology [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…Wunderlich syndrome, also known as spontaneous renal hemorrhage, is a rare yet potentially serious clinical entity characterized by non-traumatic bleeding in the perirenal space. First described by Carl Reinhold August Wunderlich in 1856, it is most commonly associated with the rupture of renal angiomyolipomas [1][2][3][4][5][6][7]. However, it can also be linked to other vascular or neoplastic lesions.…”

Section: Introductionmentioning

confidence: 99%

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Wunderlich Syndrome in a Patient With Type 1 Diabetes Mellitus: Surgical Challenges and Management Strategies

Serafio-Gómez,

Anderson-Flores,

Valenzuela-Leal

et al. 2023

Cureus

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Wunderlich syndrome, a rare manifestation of spontaneous renal hemorrhage often attributed to renal angiomyolipomas, presents a complex clinical scenario demanding nuanced management. This article delves into the multifaceted dimensions of this syndrome, dissecting its clinical, diagnostic, and therapeutic intricacies. Illustrating this complexity is the case of a 26-year-old female with Wunderlich syndrome and comorbid type 1 diabetes mellitus, revealing challenges at the intersection of these conditions. While initial intervention via laparoscopic drainage and antibiotic therapy yielded symptomatic relief, the subsequent recurrence of a renal abscess prompted a re-evaluation of the treatment strategy, culminating in a second surgical intervention. The intricate interplay between Wunderlich syndrome and diabetes introduces unique challenges, with fluctuations in hemoglobin and recurrent leukocytosis mirroring the underlying complexities of this clinical dyad. This case underscores the indispensability of a multidisciplinary approach, seamlessly integrating medical and surgical modalities, coupled with vigilant postoperative monitoring. Swift identification of complications and adaptability of the treatment plan emerged as pivotal in addressing recurrent manifestations and averting long-term sequelae. The necessity for continuous surveillance and personalized management strategies becomes evident, emphasizing Wunderlich syndrome as a clinical entity requiring bespoke attention. In conclusion, this case serves as an example, highlighting the intricate nature of Wunderlich syndrome, accentuated by the presence of type 1 diabetes mellitus. The initial therapeutic success, followed by a recurrence, underscores the need for ongoing research, paving the way for refined diagnostic and treatment paradigms. The synthesis of clinical complexities in this scenario elucidates the imperative for a comprehensive understanding, guiding future endeavors aimed at optimizing the prognosis of patients affected by this uncommon syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Wunderlich Syndrome in a Patient With Type 1 Diabetes Mellitus: Surgical Challenges and Management Strategies

Serafio-Gómez,

Anderson-Flores,

Valenzuela-Leal

et al. 2023

Cureus

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“…Les AML symptomatiques de diamètre supérieur à 4 cm et ceux de moins de 4 cm mais entraînant des symptômes doivent être traités par embolisation sélective ou néphrectomie partielle [3,4,6]. Les complications d'un AML rénal sont principalement des douleurs lombaires (41 %), une hématurie (11 %) et un saignement retro-péritonéal par rupture tumorale [4,5,6,7]. L'aspect en imagerie de l'AML est singulier, avec la présence de zones d'hypodensité adipeuses au scanner, se rehaussant de manière homogène après injection de produit de contraste [9,10,11].…”

Section: Introductionunclassified

Prévalence de la sclérose tubéreuse de Bourneville chez des patients pris en charge pour un angiomyolipome rénal

Maulaz

Malinge

Farges

et al. 2020

Progrès en Urologie

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“…The bleeding can also be bilateral (5). The case often presents as a surgical emergency needing rapid diagnostic and therapeutic measures (6). We present our experience of 9 cases treated at two central hospitals in Finland over a period of 20 years.…”

mentioning

confidence: 99%

Spontaneous Subcapsular or Perirenal Haemorrhage Caused by Renal Tumours: A Urological Emergency

Hellström

Mehik²,

Talja³

et al. 1999

Scandinavian Journal of Urology and Nephrology

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All the patients presented with flank pain, often severe and associated with a palpable mass and a reduced haemoglobin concentration. Ultrasonography was abnormal in all cases where it was used, but was able to show the tumour and haemorrhage correctly in only one case (13%). Computed tomography had a sensitivity of 71%. Seven patients underwent extrafascial nephrectomy (5 renal cell cancers, 1 malignant oncocytoma and 1 angiomyolipoma) and two with known tuberous sclerosis and bilateral renal angiomyolipomas were treated by superselective embolization. As these few cases were all individual and were collected over a long period of time, general statements about diagnosis and treatment must be approached critically. It may be concluded, however, that spontaneous perirenal haemorrhage is often a surgical emergency necessitating great efforts in terms of diagnosis and treatment. Computed tomography should be performed on all patients nowadays. If the bleeding is caused by a malignant tumour, extrafascial nephrectomy is the treatment of choice. For those with benign tumours selective embolization should be used.

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Spontaneous Rupture of Renal Tumours Presenting as Surgical Emergency

Cited by 17 publications

References 10 publications

Wunderlich Syndrome in a Patient With Type 1 Diabetes Mellitus: Surgical Challenges and Management Strategies

Wunderlich Syndrome in a Patient With Type 1 Diabetes Mellitus: Surgical Challenges and Management Strategies

Prévalence de la sclérose tubéreuse de Bourneville chez des patients pris en charge pour un angiomyolipome rénal

Spontaneous Subcapsular or Perirenal Haemorrhage Caused by Renal Tumours: A Urological Emergency

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