Abstract
Spontaneous perirenal hemorrhage (SPH), also known as Wünderlich’s syndrome, is a rare urological emergency. This article reviews the most common causes of SPH and the role of imaging in establishing the correct diagnosis and in guiding the appropriate therapy. A thorough understanding of underlying etiologies, imaging appearances, optimal imaging techniques, and follow-up protocols are crucial to recognize patients with SPH due to benign disease and avoid unnecessary nephrectomies.
Similar content being viewed by others
References
Wünderlich CRA (1856) Handbuch der Pathologie und Therapie, 2nd edn. Ebner & Seubert, Stuttgart
Kendall AR, Seney BA, Coll ME (1988) Spontaneous subcapsular renal hematoma: diagnosis and management. J Urol 139:246–250
Belville JS, Morgenstaler A, Loughlin KR, Tumeh SS (1989) Spontaneous perinephric and subcapsular renal hemorrhage: evaluation with CT, US, and angiography. Radiology 172:733–738
Sebastià MC, Pérez-Molina MO, Alvarez-Castells A, Quiroga S, Pallisa E (1997) CT evaluation of underlying cause in spontaneous subcapsular and perirenal hemorrhage. Eur Radiol 7:686–690
Zhang JQ, Fielding JR, Zou KH (2002) Etiology of spontaneous perirenal hemorrhage: a meta-analysis. J Urol 167:1593–1596
Zagoria RJ, Dyer RB, Assimos DG, Scharling ES, Quinn SF (1991) Spontaneous perinephric hemorrhage: imaging and management. J Urol 145:468–471
Bosniak MA (1989) Spontaneous subcapsular and perirenal hematomas. Radiology 172:601–602
Pode D, Caine M (1992) Spontaneous retroperitoneal hemorrhage. J Urol 147:311–318
Bosniak MA, Megibow AJ, Hulnick DH, Horii S, Raghavendra BN (1988) CT diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat. Am J Roentgenol 151:497–501
Nelson CP, Sanda MG (2002) Contemporary diagnosis and management of renal angiomyolipoma. J Urol 168:1315–1325
Kothary N, Soulen MC, Clark TW et al (2005) Renal angiomyolipoma: long-term results after arterial embolization. J Vasc Interv Radiol 16:45–50
Halpenny D, Snow A, McNeill G et al (2010) The radiological diagnosis and treatment of renal angiomyolipoma—current status. Clin Radiol 65:99–108
Chang S, Ma C, Lee S (1988) Spontaneous retroperitoneal hemorrhage from kidney causes. Eur Urol 15:281–284
Murray HW, Soave R, Collins MH (1979) Fatal retroperitoneal hemorrhage. An unusual complication of renal cortical abscess. J Am Med Assoc 241:1823–1824
Rubenstein JN, Schaeffer AJ (2003) Managing complicated urinary tract infections: the urologic view. Infect Dis Clin North Am 17:333–351
Papanicolaou N, Pfister RC, Yoder IC (1986) Spontaneous and traumatic rupture of renal cysts: diagnosis and outcome. Radiology 160:99–103
Daskalopoulos G, Karyotis I, Heretis I, Anezinis P, Mavromanolakis E, Delakas D (2004) Spontaneous perirenal hemorrhage: a 10-year experience at our institution. Int Urol Nephrol 36:15–19
Levine E, Grantham JJ, Macdougall ML (1987) Spontaneous subcapsular and perinephric hemorrhage in end-stage kidney disease: clinical and CT findings. Am J Roentgenol 148:755–758
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Diaz, J.R., Agriantonis, D.J., Aguila, J. et al. Spontaneous perirenal hemorrhage: what radiologists need to know. Emerg Radiol 18, 329–334 (2011). https://doi.org/10.1007/s10140-011-0944-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-011-0944-9