Abstract

Wunderlich syndrome is a rare fatal condition characterized by spontaneous atraumatic renal hemorrhage that confined to peri-renal and sub capsular space. It may present as an acute or insidious onset. Female has more predilection for the syndrome compared to males. Diagnosis is usually incidental. A constellation of symptoms known as Lenk’s triad described by the German physician Carl Reinhold August Wunderlich in diagnosing the condition that are acute flank pain, flank mass and hypovolemic shock. Etiologies related to the syndrome can be broadly classified into neoplastic and non-neoplastic. Commonest benign neoplastic cause of Wunderlich syndrome is renal angiomyolipoma while malignant causes such as Renal Cell Carcinoma (RCC) and liposarcoma. Non neoplastic causes such as vasculitis, aneurysm, arteriovenous malformation and cystic rupture. Wunderlich syndrome has a high mortality rate associated with the rupture of the hematoma. Early accurate diagnosis is crucial in patient’s intervention and management. Multimodality treatment is available in Wunderlich syndrome such as highly specific embolization, surgeries as well as conservative. Treatments are tailored according to the hematoma size, availability specialty services and patient’s hemodynamic status.

Keywords:Wunderlich syndrome; Angiomyolipoma; Hematoma