A tale of Wünderlich syndrome

Wunderlich syndrome is a rare entity characterized by acute onset of spontaneous, non-traumatic renal hemorrhage into the subcapsular and perirenal spaces. It can be fatal if not promptly recognized clinically and treated aggressively. We report a case of a 63-year-old Caucasian female who was presented to the emergency department with acute onset of sharp abdominal and right flank pain, and hypotension. An urgent abdominal and pelvic computed tomography scan with contrast demonstrated a large (13 × 12 × 8.5 cm) right perinephric hematoma of unknown etiology. The patient subsequently underwent renal angiogram that demonstrated active extravasation of the right superior renal artery. She underwent successful embolization procedure and responded well to fluid resuscitation. She remained hemodynamically stable and was discharged home without further events.