J Korean Soc Hypertens.  2012 Jun;18(2):71-74. 10.5646/jksh.2012.18.2.71.

Spontaneous Renal Hematoma Caused by Hypertension with Left Ventricular Hypertrophy

• Park BW
• Kong MG
• Ju HY
• Chung JW
• Bang DW
• Hyon MS
• Kwon SH
• Hong SS

• KMID: 1436343
• DOI: http://doi.org/10.5646/jksh.2012.18.2.71

Abstract

Spontaneous renal hematoma is rare. We report a 43-year-old man presented with sudden left flank pain and severe hypertension. Renal hematoma was confirmed on computed tomography. Renal angiography showed no active bleeding or vascular malformation. Echocardiography showed severe concentric left ventricular hypertrophy. Hypertension was the only cause for the condition. Symptoms and size of the hematoma decreased on antihypertensive medication and conservative treatment. Severe hypertension might have a role for developing renal hematoma.

Keyword

Kidney; Hematoma; Hypertension; Left ventricular hypertrophy

MeSH Terms

Adult
Angiography
Echocardiography
Flank Pain
Hematoma
Hemorrhage
Humans
Hypertension
Hypertrophy, Left Ventricular
Kidney
Vascular Malformations

Figure

• 

  Fig. 1 M-mode echocardiography at the papillary muscle level. Dilated left ventricular dimension with underlying marked hypertrophy and borderline systolic function (ejection fraction was 52%). Left ventricular end-diastolic dimension was 64 mm. Septal and posterior wall thickness was 22 and 21 mm, respectively.

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  Fig. 2 Abdominal computed tomography. (A) Transverse plane. (B) Coronal plane. Huge subcapsular hematoma (*) in left kidney with small amount of hemoretroperitoneum (small arrows). Extravasation of contrast at the lower pole (big arrow).

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  Fig. 3 Contrast enhanced renal magnetic resonance imaging after 7 days. (A) Coronal plane. (B) Magnification of left kidney. Complicated cyst (1.2 × 0.7 cm) with low signal intensity is noted in lower pole without enhancement (big arrow). No change in subcapsular hematoma (*) and decrease in amount of hemoretroperitoneum (small arrows). No evidence of contrast extravasation.

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