Page Kidney in Wunderlich Syndrome Causing Acute Renal Failure and Urosepsis: Successful Timely Minimally Invasive Management of a Devastating Clinical Entity
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 6
Abstract
Wunderlich Syndrome (WS) is an uncommon condition where acute onset of spontaneous bleeding occurs into the subcapsular and perirenal spaces. It can prove fatal if not recognized and treated aggressively at the appropriate time. A 32-year-old male diagnosed elsewhere as acute renal failure presented with tender left loin mass, fever and hypovolemic shock with serum creatinine 8.4 mg/dl. He was started on higher antibiotics and initiated on haemodialysis. Ultrasonogram (USG), Non-Contrast Computed Tomography (NCCT) and Magnetic Resonance Imaging (MRI) showed bilateral perirenal subcapsular haematomas – right 3.6 x 3.1 cm and left 10.3 x 10.3 cm compressing and displacing left kidney, fed by capsular branch of left renal artery on CT angiogram. Initial aspirate was bloody but he persisted to have febrile spikes, renal failure and urosepsis and he was managed conservatively. Repeat NCCT 10 days later revealed left perinephric abscess and Percutaneous Drainage (PCD) was done. Patient improved, serum creatinine stabilized at 2 mg/dl without haemodialysis and PCD was removed after two weeks. To conclude, bilateral idiopathic spontaneous retroperitoneal haemorrhage with renal failure is a rare presentation. This case highlights the need for high index of suspicion, the role of repeated imaging and successful minimally invasive management with timely PCD and supportive care.
Authors and Affiliations
Sundaramoorthy VijayGanapathy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Jayaram Sreenivas
Keywords
Related Articles
- EP ID EP350230
- DOI 10.7860/JCDR/2017/24731.9963
- Views 55
- Downloads 0
The Relationship between Serum Level of Vitamin D3 and the Severity of New Onset Rheumatoid Arthritis Activity
Introduction: Rheumatoid Arthritis (RA) is a systemic inflammatory disease which typically involves wrists, ankles, and finally every joint. Some of studies have reported a reverse relationship between the level of vitam...
Familial Ankyloglossia -A Rare Report of three Cases in a Family
Images in Medicine
Assessing the Impact of a Structured Tuberculosis Training Activity on the Knowledge and Attitude of Community Volunteers
ABSTRACT Introduction: With the paucity of health workforce for Tuberculosis (TB) in India a cadre of trained community volunteers can effectively contribute to the prevention and control of TB in a particular community....
Use of Multi-Response Format Test in the Assessment of Medical Students' Critical Thinking Ability
Introduction: To evaluate students critical thinking skills effectively, change in assessment practices is must. The assessment of a student’s ability to think critically is a constant challenge, and yet there is conside...
Estimation of Correlation between Chronological Age, Skeletal Age and Dental Age in Children: A Cross-sectional Study
Introduction: In the modern era, identification and determination of age is imperative for diversity of reasons that include disputed birth records, premature delivery, legal issues and for validation of birth certificat...