Wunderlich syndrome

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Acute left flank pain.

Patient Data

Age: 60 years
Gender: Female
ct

A 35 x 30 mm fat-containing partially exophytic mass is present at the mid-portion of the left kidney accompanied by a 130 x 70 x 75 mm subcapsular haematoma and perinephric fat stranding. Some fluid is also present in front of the left iliopsoas muscle. Features are compatible with Left renal angiomyolipoma with haemorrhage (Wunderlich syndrome). 

In imaged portions of the lower thorax; moderate left-sided pleural effusion is present; accompanied by adjacent parenchymal collapse.

Case Discussion

Wunderlich syndrome is a rare condition in which spontaneous non-traumatic renal haemorrhage occurs into the subcapsular and perirenal spaces. Angiomyolipoma is the commonest neoplastic aetiology.

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