Etiology Of Spontaneous Perirenal Hemorrhage: A Meta-Analysis

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Apr 2002Etiology Of Spontaneous Perirenal Hemorrhage: A Meta-Analysis Jian Qing Zhang, Julia R. Fielding, and Kelly H. Zou Jian Qing ZhangJian Qing Zhang Current address: Department of Radiology, First Hospital of Wenzhou Medical College, Zhejiang, People’s Republic of China. More articles by this author , Julia R. FieldingJulia R. Fielding Current address: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599. More articles by this author , and Kelly H. ZouKelly H. Zou Current address: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115. More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65160-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determine the most common etiology of spontaneous perirenal hemorrhage. Materials and Methods: A MEDLINE search of the English language literature from 1985 to 1999 revealed 47 publications and 165 cases of spontaneous renal hemorrhage meeting our study entry criteria. These criteria were presentation of raw data including imaging modality, pathological confirmation (123 cases) or long-term (greater than 2 years) (42) imaging and/or clinical followup and no history of recent trauma, anticoagulant use, dialysis or renal transplant. Meta-analysis was performed using analysis of counts derived from contingency tables and pooled and stratified analysis. Results: Hemorrhage was identified by ultrasound in 56 of 100 cases (56%) and by computerized tomography (CT) in all 135 cases assessed (100%). Etiology was correctly identified with an overall sensitivity and specificity of 0.11 and 0.33 for ultrasound and 0.57 and 0.82 for CT. Angiography in 81 cases revealed active bleeding in 11. The most common etiology of spontaneous renal hemorrhage was benign or malignant neoplasm (101 cases, 61%) with angiomyolipoma being predominant (48) followed closely by renal cell carcinoma (43). Vascular disease was the next most common offender (28 cases, 17%) with polyarteritis nodosa occurring most frequently (20). Conclusions: The most common cause of spontaneous perirenal hemorrhage is renal neoplasm and approximately 50% of such neoplasms are malignant. CT is the method of choice for evaluation of perirenal hemorrhage, although its sensitivity for detection of underlying etiology is only moderate. 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Google Scholar From the Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 167Issue 4April 2002Page: 1593-1596 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordskidneymeta-analysishemorrhageMetricsAuthor Information Jian Qing Zhang Current address: Department of Radiology, First Hospital of Wenzhou Medical College, Zhejiang, People’s Republic of China. More articles by this author Julia R. Fielding Current address: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599. More articles by this author Kelly H. Zou Current address: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115. More articles by this author Expand All Advertisement PDF DownloadLoading ...