Spontaneous Perinephric Hematoma Research Articles

Perinephric Abscess Superimposed on a Spontaneous Perinephric Hematoma

Perinephric Abscess Superimposed on a Spontaneous Perinephric Hematoma

Rare Case of Spontaneous Perinephric Hematoma with Two-Year Follow-Up

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.

Spontaneous Perinephric Hematoma with Newer Oral Anticoagulation in Kidney Transplant Recipient

Spontaneous Perinephric Hematoma with Newer Oral Anticoagulation in Kidney Transplant Recipient

Spontaneous perinephric hemorrhage associated with urolithiasis in pregnancy.

Spontaneous perinephric hematoma in the absence of anticoagulation, arteritis, or trauma is uncommon. We report the case of a postpartum patient with nephrolithiasis who initially presented to the obstetric service with a spontaneous perinephric hemorrhage.

Unusual renal manifestations of Wegener's granulomatosis: Report of two cases

Two patients with previously undescribed renal manifestations of Wegener's granulomatosis are described. A 24 year old man, who presented with typical necrotizing granulomatous sinus disease and cavitary pulmonary lesions, had multiple bilateral renal arterial aneurysms demonstrated angiographically. One of these aneurysms ruptured, leading to a massive perinephric hematoma. The bleeding artery was successfully occluded with Gelfoam ® embolization, thereby obviating the need for nephrectomy. A 60 year old woman presented with glomerulonephritis and mononeuritis multiplex two years before the development of classic necrotizing granulomatous inflammation of her sinuses and nose, along with pulmonary nodules. In addition, her left ureter became obstructed due to necrotizing vasculitis of the periureteral vessels. Both patients responded dramatically to cyclophosphamide therapy. The diagnosis of Wegener's granulomatosis should be considered in patients who present with multiple renal aneurysms, a spontaneous perinephric hematoma, necrotizing glomerulitis or ureteral obstruction due to vasculitis, even though the characteristic granulomatous respiratory involvement may be absent at that time. It is important to recognize these unusual renal manifestations as features of Wegener's granulomatosis because of the therapeutic efficacy of cytotoxic immunosuppressive agents in this disease.

Spontaneous perinephric hematoma secondary to renal tumor

1. 1. Two case reports of spontaneous perinephric hematoma secondary to renal tumor are presented. In the first patient, the hematoma was extracapsular and the tumor was large. The second patient had a subcapsular hematoma and the kidney appeared grossly normal. Microscopic examination revealed a small carcinoma in the cortex which was the cause of the bleeding. 2. 2. The etiology of spontaneous perinephric hematoma includes a multiplicity of disease processes, the more common being nephritis, renal tumors, renal artery aneurysm, arteriosclerosis and periarteritis nodosa. It is of interest that no renal disease could be demonstrated in a significant number of reported cases. 3. 3. The possibility of a renal tumor being the cause of the bleeding should be kept in mind since a spontaneous hematoma may be the first clinical sign of this lesion. 4. 4. The diagnosis of perinephric hematoma is rarely made since the clinical picture and pyelographic findings are not pathognomonic. It should be suspected in all patients with a history of pain in the flank and presence of a renal mass together with evidence of internal bleeding. The most important diagnostic feature is low or decreasing hemoglobin and hematocrit. 5. 5. The treatment of choice is nephrectomy which is often a life-saving procedure. However, whenever possible the status of the opposite kidney should be determined preoperatively since the underlying cause of the bleeding may be bilateral