Clinical Analysis of Spontaneous Renal Rupture with Perirenal Hemorrhage

Koh, Dong Hee; Kim, Se Joong; Ahn, Hyun Soo

Abstract

PURPOSE: Spontaneous renal rupture with perirenal hemorrhage is a relatively uncommon, but often diagnostically challenging, condition. Accurate diagnosis requires a combination of clinical information and radiological imaging. The etiology and clinical aspects of spontaneous renal rupture with perirenal hemorrhage were studied.
MATERIALS AND METHODS
Twelve cases(7 women and 5 men, mean age 44.5 years) of spontaneous renal rupture with perirenal hemorrhage in our hospital were retrospectively analyzed for symptoms, imaging studies, etiology, and treatment modalities. Twenty-five cases(15 women and 10 men, mean age 43.4 years) reported in Korea were also reviewed.
RESULTS
In our 12 cases, the etiology was neoplasm in 8(6 angiomyolipoma, 1 renal cell carcinoma, and 1 metastatic cancer), renal vascular disease in 3(2 arteriovenous malformation and 1 polyarteritis nodosa), and unidentified in 1. Radiologic studies(computed tomography and/or renal angiography) were done in all cases and 10(83.3%) were accurately diagnosed. Nephrectomy was performed in 5 cases, arterial embolization in 6, and conservative management in 1. In all 37 cases reported in Korea, including our own, neoplasm(26 cases, 70.3%) was the most common cause and angiomyolipoma(18 cases) was the leading cause. Computed tomography was performed in 33 cases, and 26 cases(78.8%) were correctly diagnosed. Nephrectomy was performed in 21 cases(56.8%).
CONCLUSIONS
The most common cause of spontaneous renal rupture with perirenal hemorrhage is angiomyolipoma. Computed tomography is the method of choice for the evaluation of spontaneous renal rupture with perirenal hemorrhage.