Arterial embolization prior to nephrectomy in Wünderlich syndrome: a case report
Keywords:
ANCIANO; CUMPLIMIENTO DE LA MEDICACIÓN; CUMPLIMIENTO Y ADHERENCIA AL TRATAMIENTO; HIPERTENSIÓN., AGED; MEDICATION ADHERENCE; TREATMENT ADHERENCE AND COMPLIANCE; HYPERTENSION., : IDOSO; ADESÃO À MEDICAÇÃO; COOPERAÇÃO E ADESÃO AO TRATAMENTO; HIPERTENSÃO.Abstract
Introduction: wünderlich syndrome, or spontaneous renal hemorrhage, is an uncommon entity that usually presents as an urgent situation.
Objective: to present a case highlighting the importance of imaging techniques in achieving timely diagnosis and minimally invasive therapeutic management to control complications, particularly hypovolemic shock.
Case report: a 28-year-old female with no reported comorbidities, maternal pathological history of sudden death due to acute abdominal pain 15 years ago, suspected retroperitoneal hematoma. She presented with a clinical picture of approximately three months’ evolution consisting of intermittent hematuria and right lumbar pain. Later, she developed exacerbation of symptoms associated with nausea and vomiting. Physical examination revealed cutaneous-mucosal pallor, globular abdomen, tenderness on superficial palpation in the epigastrium and right iliac fossa, with a palpable mass extending from the epigastrium to the right flank. Imaging studies reported retroperitoneal hematoma; urgent selective arterial embolization was performed, achieving consequent hemodynamic stability. Right nephrectomy was decided due to the presence of a renal tumor.
Conclusion: wünderlich syndrome is a rare entity that represents a diagnostic challenge. Treatment depends on the patient’s hemodynamic condition. Selective arterial embolization appears as a safe and effective way to address the emergency prior to definitive nephrectomy.
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