Abstract
Background: Spontaneous perinephric hematoma with no associated pathology or provocation is a rare clinical phenomenon. The hematoma requires a two-year interval for a favorable hematoma resolution, and no associated hypertension or renal scarring. Aims: Evidence of the efficacy of conservative management for spontaneous perinephric hematoma with a 2-year follow up. Case Presentation: A previously healthy 38-year-old woman, presented with a sudden onset of left flank pain, associated with fatigue and pallor. The patient remained hemodynamically stable with no significant history or associated provocations identified. Conclusion: The acute management strategy is favorable in such condition, as the hematoma remains under tamponade in the retroperitoneal space, regardless of the size and organ displacement. Closed observation, serial blood investigation and repeated CT scans are vital to assist in the decision to intervene.
Highlights
Spontaneous perinephric hematoma was first described in 1856 by Wunderlich, which is defined as the accumulation of blood in the perinephric space from non-traumatic and non-iatrogenic cause [1] [2]
Serial blood investigation and repeated CT scans are vital to assist in the decision to intervene
The initial management of spontaneous perinephric hematoma is important as acute uncontrolled bleeding can be life threatening
Summary
Spontaneous perinephric hematoma was first described in 1856 by Wunderlich, which is defined as the accumulation of blood in the perinephric space from non-traumatic and non-iatrogenic cause [1] [2]. Regardless of the pathology and the origin of the bleeding, spontaneous perinephric hematoma has clinical manifestation described as Lenk’s triad, associated with acute flank pain, flank mass and hypovolemic-shock. Some clinicians favor exploratory surgery with high possibility of nephrectomy, while others recommended conservative management [5]. Favoring the latter mode of management, we present an unusual case of spontaneous perinephric hematoma effectively treated conservatively. Spontaneous perinephric hematoma with no associated pathology or provocation is a rare clinical phenomenon. Aims: Evidence of the efficacy of conservative management for spontaneous perinephric hematoma with a 2-year follow up. Conclusion: The acute management strategy is favorable in such condition, as the hematoma remains under tamponade in the retroperitoneal space, regardless of the size and organ displacement. Serial blood investigation and repeated CT scans are vital to assist in the decision to intervene
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
