Services on Demand
Journal
Article
Indicators
- Cited by SciELO
- Access statistics
Related links
- Similars in SciELO
Share
Revista mexicana de urología
On-line version ISSN 2007-4085Print version ISSN 0185-4542
Abstract
MARTINEZ-LOPEZ, Héctor Iván; LEON-VILCHIS, Fernando; JIMENEZ-LOPEZ, Luis Alfredo and RICARDEZ-ESPINOZA, Abel Antonio. Wunderlich syndrome in tuberous sclerosis: Conservative Management. Rev. mex. urol. [online]. 2018, vol.78, n.4, pp.303-309. Epub June 25, 2021. ISSN 2007-4085. https://doi.org/10.24245/revmexurol.v78i4.2019.
BACKGROUND:
Wunderlich syndrome, also called spontaneous retroperitoneal hemorrhage, is a very rare clinical entity. Its primary kidney tumor etiology is angiomyolipoma and accounts for 60% of the cases.
CLINICAL CASE:
A 22-year-old woman presented with sudden onset of pain in the right renal fossa. Upon hospital admission, the patient was conscious, lucid, and had mild hypotension. Physical examination revealed signs and symptoms of tuberous sclerosis, a soft, depressible abdomen that was painful upon palpation, a palpable mass in the right renal fossa, and no signs of peritoneal irritation. A tomography scan identified a right well-defined subcapsular hematoma with multiple bilateral angiomyolipomas. Wunderlich syndrome was diagnosed and tuberous sclerosis was confirmed through major criteria. Because the patient was hemodynamically stable she was managed conservatively, with serial hematocrit surveillance, intravenous fluids, and complete bedrest. The patient had satisfactory progression.
CONCLUSION:
Treatment of Wunderlich syndrome should begin with an evaluation of the hemodynamic status of the patient. In case of instability, the indication is urgent surgery. We present herein the first report in the medical literature of an exceptional form of Wunderlich syndrome, concomitant with tuberous sclerosis, that was managed conservatively.
Keywords : Wunderlich syndrome; Tuberous sclerosis; Spontaneous retroperitoneal hemorrhage.