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Idiopathic Atraumatic Renal Hemorrhage: A Case Report

Year: 2025

Type: article

Abstract: INTRODUCTION: Wunderlich syndrome (WS) is a rare condition characterized by spontaneous, atraumatic renal hemorrhage. It often presents with non-specific symptoms and is typically diagnosed through computed tomography (CT). The most common presentation of WS includes the Lenk triad, which consists of flank pain, a palpable flank mass, and hypovolemic shock. If diagnosis and treatment are delayed, WS can rapidly progress and lead to unfavorable patient outcomes. CASE REPORT: A 65-year-old male presented to the emergency department with severe sudden-onset left flank pain with subsequent CT angiogram demonstrating an actively bleeding left renal hematoma. The patient was managed conservatively with supportive care. His vitals remained stable, and he did not require any surgical or vascular interventions. CONCLUSION: Wunderlich syndrome is a spontaneous renal or perinephric hemorrhage occurring in the absence of trauma; it is rarely included in the differential for patients with flank pain but can become life-threatening when not recognized.

Source: Clinical Practice and Cases in Emergency Medicine

DOI: 10.5811/cpcem.33528

Authors: Tabitha Ranson, Zachary Ostapowicz, Gregory Ruddy, Leah Joyner

Institutions: Kansas City University, Mercy Hospital

Language: English

Topic: Case Reports on Hematomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $500