Bilateral spontaneous perinephric hematoma

ABSTRACT

A-55-year-old man presented with a history of generalized swelling all over the body and uremic symptoms. Physical examination revealed pallor, anasarca, and hypertension. A gradual elevation of serum creatinine level from 1.6 mg/dL to 6.49 mg/dL was documented within 3 weeks. Urinalysis did not show any abnormal sing. Ultrasonography revealed the right kidney sized 9.5 x 3 cm and the left kidney, 10 x 4.9 cm, with large bilateral perinephric collections. Doppler ultrasonography revealed a 1.3 cm midopole aneurysm in the right kidney and multiple left renal aneurysms. Computed tomography revealed heterogeneous bilateral collection with fascial thickening in the peripheral spaces suggestive of bilateral perirenal hematomas with bilateral renal artery aneurysms. He was subjected to bilateral renal angiography and coiling of the aneurysms. Perinephric collection was evacuated by flank incision. Subcapsular renal hematomas occur secondary to variable etiologies and Page Kidney phenomenon can les to kidney failure. When occurs unilaterally, it can be managed expectantly, but page kidney in a solitary unit or bilateral Page kidney can lead to acute kidney failure, necessitating intervention to avoid the irreversible kidney damage