Complicated UTI – A Rare Cause of Spontaneous Perirenal Hematoma.

Spontaneous renal hemorrhage is an unusual complication of urinary tract infection. A 56-year-old man, diabetic with single functional kidney was admitted with fever and abdominal pain for one day. He had pyuria and an obstructed renal moiety due to a lower ureteric stone. On evaluation, he was found to have a left perirenal hemorrhage. Drainage of the obstructed system was performed and hemorrhage was managed conservatively; in the postoperative period patient remained stable and was discharged. In conclusion, complicated urinary tract infection is a rare cause of the spontaneous perirenal hematoma and needs a high vigilance for diagnosis and management.

A Renal Perforating Artery Mistaken for Arterial Bleeding after Percutaneous Renal Biopsy: A Case Report

Perirenal hematoma after a renal biopsy is a common complication that usually resolves spontaneously, but this rarely requires transfusions or surgical/radiological intervention. We report here on a case of a renal perforating artery that was mistaken for renal arterial bleeding in a 53-year-old woman who was complicated with perirenal hematoma after undergoing a percutaneous renal biopsy. On the color and pulsed wave Doppler ultrasonography, linear blood flow was seen in the perirenal hematoma, which extended perpendicularly from the renal parenchyma into the perirenal space, and this linear blood flow exhibited an arterial pulse wave. On CT angiography, the renal perforating artery was demonstrated as a curvilinear vessel coursing tangentially to the renal margin and we decided that it was a pseudolesion caused by the renal perforating artery. A renal perforating artery may be mistaken for renal arterial bleeding after a percutaneous renal biopsy. A renal perforating artery and arterial bleeding can be differentiated by the location and shape seen on a color Doppler examination and the pulse waves characteristics.

Development of a Perirenal Hematoma after Hula-Hooping

The development of a perirenal hematoma is rare and primarily the result of trauma, malignancy, or a connective tissue disease. Infrequently, a continuous or even mild trauma can cause a perirenal hematoma. Here, we report a case involving the development of a perirenal hematoma after excessive hula-hooping in the absence of a major trauma history.

A Case of Massive Perirenal Hematoma in a Patient with Hemorrhagic Fever with Renal Syndrome / 대한신장학회잡지

Hemorrhagic fever with renal syndrome is characterized clinically by the triad of fever, hemorrhage and renal failure. The hemorrhage in hemorrhagic fever with renal syndrome(HFRS) varies from transient petechial lesions to fulminant and massive bleeding. The latter can be an important cause of death in HFRS. We here report a case of massive perirenal hematoma in a patient with HFRS. A 17-year-old male was admited to our hospital presenting with fever, sore throat, nausea and oliuria. Computed tomography was performed at the 2nd day of hospitalization due to abruptly developing right flank pain and anemia and showed perirenal hematoma on the right kidney. He was diagnosed as HFRS and treated with hemodialysis, fluid infusion, and transfusion. There was no evidence of further blood loss at the 7th day of hospitalization. After conservative treatment, he recovered from HFRS.

A Case of Spontaneous Repture of Renal Artery Aneurysm in Polyarteritis Nodosa / 대한신장학회잡지

Although renal aneurysmal formation in polyarteritis nodosa is common, it is rare to form complication of perirenal hematoma caused by spontaneous rupture of renal aneurysm. It should be differentiated from renal tumor, arterio-venous malforrnation, renal infarction, coagulopathy, and acute hydronephrosis in considering the cause of perirenal hematoma. In addition to that, it is a potential life-threatening complication and its early recognition and prompt treatrnent are emphasized. We describe a patient with polyarteritis nodosa who developed spontaneous perinenal hematoma due to repture of renal aneurysm, who had nonspecific symptoms. We thought polyarteritis nodosa based on present illness and clinical background, then immediately performed angiography and coil embolization. So the patient could be treated with cyclophosphamide and steroid successfully. Polyarteritis nodosa is a relatively rare disease, but should be included as one of the differential diagnosis whenever perirenal hematoma occurs.

A Case of Spontaneous Perirenal Hematoma due to Metastatic Choriocarcinoma to the Perirenal Fat / 대한비뇨기과학회지

Spontaneous perirenal hematoma can occur during the course of a varied group of diseases. It is not a rare disease. The diagnosis is based on either the sudden or insidious onset of abdominal or flank pain, abdominal distention, the symptoms and signs of internal bleeding, and the appearance of a mass in either upper quadrant. The picture of the acute surgical condition of the abdomen is often seen. The treatment is surgery and prognosis depends upon the underlying disease, the degree of hemorrhage and the promptness of treatment. We experienced one case of spontaneous perirenal hematoma due to metastatic choriocarcinoma only to the perirenal fat, not renal parenchyme.