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CT evaluation of underlying cause in spontaneous subcapsular and perirenal hemorrhage
M C Sebastià1, M O Pérez-Molina, A Alvarez-Castells
1Department of Radiology, IDI, Hospital General Universitari Vall d'Hebron, E-08 305 Barcelona, Spain.
Insights
Computed tomography (CT) effectively identifies spontaneous subcapsular or perinephric hemorrhage (SPH) and its underlying causes in most cases. CT is a valuable tool for diagnosing SPH and determining its origin.
Area of Science:
- Radiology
- Urology
- Nephrology
Background:
- Spontaneous subcapsular or perinephric hemorrhage (SPH) can arise from various renal and adrenal pathologies.
- Accurate identification of the underlying cause is crucial for appropriate patient management.
Purpose of the Study:
- To evaluate the efficacy of computed tomography (CT) in identifying the cause and extent of spontaneous subcapsular or perinephric hemorrhage (SPH).
Main Methods:
- Retrospective analysis of CT scans from 13 patients diagnosed with SPH.
- Review of underlying causes including angiomyolipomas, renal cell carcinomas, and other lesions.
Main Results:
- CT accurately detected hematomas in 100% of cases (13/13).
- CT identified the underlying cause in 100% of cases with identifiable renal or adrenal lesions (12/12), achieving 91.6% diagnostic accuracy (11/12).
- One case of undiagnosed coagulation disorder was not associated with an identifiable lesion.
Conclusions:
- Computed tomography is a highly sensitive and specific imaging modality for the initial evaluation of SPH.
- CT facilitates the diagnosis of hemorrhage and aids in pinpointing the underlying etiology, guiding clinical decision-making.
Abstract:
We evaluated the CT scans of 13 patients with spontaneous subcapsular or perinephric hemorrhage (SPH) associated with these underlying causes: 4 angiomyolipomas, 2 renal cell carcinomas, 1 renal metastatic malignant melanoma, 1 ruptured renal artery aneurysm, 1 adrenal myelolipoma, 1 ruptured renal abscess, 2 ruptured hemorrhagic cysts, and 1 patient with undiagnosed coagulation disorder. Our objective was to ascertain whether an underlying cause of SPH was identifiable by CT, and to determine the extension of the hematomas. Computed tomography identified the hematoma in all 13 cases (sensitivity 100 %). In all 12 cases in which there was a renal or adrenal anatomic lesion, the underlying cause was identified with CT (100 %), with correct diagnosis in 11 cases (91.6 %). The case in which no lesion was identified was the undiagnosed coagulation disorder. We conclude that CT is a useful technique for the initial evaluation of SPH, permitting diagnosis of hemorrhage and identification of the underlying cause.