Idiopathic Spontaneous Renal Rupture

ABSTRACT

Spontaneous renal rupture is a rare, but important, clinical problem that heralds a variety of kidney abnormalities. Tumors are the most common cause, followed by vascular disease, infection, nephritis and blood dyscrasia. In some cases, no underlying abnormality of the kidney can be found. The patients usually present with an acute onset of flank pain, a tender mass, and common symptoms and signs of shock. In most cases rapid surgical intervention is necessary and nephrectomy remains the treatment of choice in cases of a ruptured tumor. A 47 year-old female, who had been in good health previously, was hospitalized because of a sudden onset of left flank pain for one day. There was no history of trauma. Physical examination revealed marked tenderness and guarding over the left flank abdomen. A perirenal hematoma on the left side was seen with abdominal sonography. Computerized tomography demonstrated a large perirenal hematoma and a kidney rupture caudally. Selective renal angiography demonstrated an active bleeding over the lower pole, so a coil embolization and nephrectomy were performed. The histological examination of the kidney revealed no underlying abnormality. We report a case of idiopathic spontaneous renal rupture, along with a literature review.