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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
PINILLA, Rafael; LOPEZ, Sarah; QUINTANA, Juan Carlos and AL-EZZI AL- MALAHI, Ahmed. Wünderlich syndrome: case presentation and literature review. rev. colomb. cir. [online]. 2009, vol.24, n.1, pp.56-61. ISSN 2011-7582.
Introduction. Spontaneous renal hemorrhage, or Wünderlich´s syndrome, is a rare entity, which because of its urgent, and sometimes life-threatening, nature, has important clinical significance. Diagnosis is made by imaging techniques. Sometimes the clinical condition leads to urgent surgical intervention. We report a case of Wündelich´s syndrome of tumor etiology and a literature review. Materials and methods. Clinical report of one case and literature review. Results. We describe a case where the surgical finding was necrobiosis of a clear cell hypernephroma, managed in our service by emergency nephrectomy, with good postoperative results. Discussion. Wünderlich´s syndrome is an infrequent clinical entity, many times not suspected by the clinical findings in the absence diagnostic imaging. The physician should be familiar with its existence, its potential causes, and the relative frequency of each cause. Because of the relative weight of the renal expansive pathological processes, the first diagnostic hypothesis should be an underlying renal tumor. Management should be careful clinical monitoring until cessation of bleeding, or, when necessary, the more aggressive conduct of emergency nephrectomy, because of the potential presence of organic lesions generating hemorrhage.
Keywords : kidney; kidney neoplasms; carcinoma; renal cell; hemorrhage; nephrectomy.