Spontaneous renal subcapsular hematoma renal angiography as a diagnostic aid

Prior to the development of angiography, a definite diagnosis of spontaneous subcapsular renal hematomaa was not often made preoperatively. The classic triad of blood loss, pain, and mass on the affected side is seldom presented by the patient. The one constant finding on scout film is an enlarged renal shadow, presenting a problem in differential diagnosis. Chief among cause of subcapsular renal hemorrhage are trauma, tumor, infarct, arteritis, and bleeding diathises. Selective renal arteriography gives specific information about the renal vascular supply and the state of the renal parenchyma not available by other means. Diagnosis of subcapsular renal hematom is facilitated by this modality. A correct diagnosis of subcapsular renal hematoma may well spare an otherwise innocent kidney. A review of current literature was undertaken, and three documented cases of spontaneous subcapsular hematoma diagnosed prior to surgery and confirmed at surgery are presented.