Spontaneous Renal Hemorrhage: A Case Report and Clinical Protocol

Spontaneous renal hemorrhage is an uncommon entity with potentially serious consequences. We present a 68-year-old female with a three-day history of progressively worsening left-sided flank pain due to spontaneous left renal hemorrhage without a history of trauma or anticoagulation. The patient's symptoms improved with conservative management and she was discharged after several days of observation. However, the patient was readmitted the next day with progressively worsening pain due to hematoma expansion from active extravasation. On the second admission, interventional radiology successfully embolized the affected vessels and the patient improved rapidly. The hematoma decreased in size on follow-up exams but no etiology was discovered. Early arterial embolization may have improved outcomes in this case and we argue that it should be considered early in the management of all patients with spontaneous renal hemorrhage.