Wunderlich Syndrome – Minimally Invasive Treatment
DOI:
https://doi.org/10.63682/jns.v14i19S.4784Keywords:
Wunderlich Syndrome, Renal, Angiomyolipoma, Renal Artery EmbolizationAbstract
Wunderlich Syndrome (WS), first described in 1856, is a rare, potentially life-threatening condition caused by spontaneous retroperitoneal hemorrhage, often from renal angiomyolipoma (AML). Symptoms include sudden flank pain, a palpable renal mass, and hypotension, making early diagnosis challenging. WS is most commonly caused by benign renal AMLs and malignant renal cell carcinoma. Treatment depends on the underlying cause, hemorrhage severity, and patient’s hemodynamic status, ranging from conservative care to more invasive options like embolization and surgery.
This case report discusses a 60-year-old woman who presented with acute right flank pain, pallor, and dizziness. Imaging revealed a large AML in the right kidney with significant hemorrhage. The patient underwent successful emergency renal artery embolization (RAE), which stabilized her condition and stopped the bleeding. Post-procedure imaging confirmed the efficacy of RAE, emphasizing its role in managing WS, offering renal preservation with fewer complications compared to nephrectomy
Downloads
Metrics
References
Parmar N, Langdon J, Kaliannan K, Mathur M, Guo Y, Mahalingam S. Wunderlich syndrome: wonder what it is. Current Problems in Diagnostic Radiology. 2022 Mar 1;51(2):270-81.
Nerli RB, Ghagane SC, Kadeli V, Nutalpati S, Mohan S, Hiremath MB. Bleeding angiomyolipoma mimiking a ruptured adrenal tumour. Urology Case Reports. 2020 Jan 1;28:101031.
Medda M, Picozzi SC, Bozzini G, Carmignani L. Wunderlich's syndrome and hemorrhagic shock. Journal of emergencies, trauma, and shock. 2009 Sep 1;2(3):203-5.
Moratalla MB. Wunderlich’s syndrome due to spontaneous rupture of large bilateral angiomyolipomas. Emergency Medicine Journal. 2009 Jan 1;26(1):72.
Larbi H, Hassan I, Cherraqi A, Mohammed A, Ahmed A. Wunderlich syndrome: rare and unrecognized emergency. Urology Case Reports. 2022 Jul 1;43:102093.
Park BK. Renal angiomyolipoma: radiologic classification and imaging features according to the amount of fat. American Journal of Roentgenology. 2017 Oct;209(4):826-35.
Koesbandono, Sidipratomo P, Utomo R, Tansol C, Kurniawan YC. Transarterial embolization in Wunderlich syndrome due to recanalization of giant renal angiomyolipoma pseudoaneurysm: a case report and literature review. Egyptian Journal of Radiology and Nuclear Medicine. 2024 Jul 5;55(1):132.
Wright T, Sooriakumaran P. Renal angiomyolipoma presenting with massive retroperitoneal haemorrhage due to deranged clotting factors: a case report. Cases Journal. 2008 Dec;1:1-3.
Oesterling JE, Fishman EK, Goldman SM, Marshall FF. The management of renal angiomyolipoma. The Journal of urology. 1986 Jun;135(6):1121-4.
Albi G, Del Campo L, Tagarro D. Wünderlich's syndrome: causes, diagnosis and radiological management. Clinical radiology. 2002 Sep 1;57(9):840-5.
Moorhead JD, Fritzsche P, Hadley HL. Management of hemorrhage secondary to renal angiomyolipoma with selective arterial embolization. The Journal of urology. 1977 Jan;117(1):122-3.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
