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Congress: ECR24
Poster Number: C-18382
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-18382
Authorblock: M. T. Sidiropoulou, E. T. Psoma, M. Alexandratou, A. Papachristodoulou, A. Michalopoulos, L. Kougias, V. Rafailidis, A. A. Hatzidakis, P. K. Prassopoulos; Thessaloniki/GR
Disclosures:
Maria Theodoros Sidiropoulou: Nothing to disclose
Elisavet Trifon Psoma: Nothing to disclose
Maria Alexandratou: Nothing to disclose
Angeliki Papachristodoulou: Nothing to disclose
Aristeidis Michalopoulos: Nothing to disclose
Leonidas Kougias: Nothing to disclose
Vasileios Rafailidis: Nothing to disclose
Adam A. Hatzidakis: Nothing to disclose
Panos K. Prassopoulos: Nothing to disclose
Keywords: Abdomen, Interventional vascular, Kidney, Catheter arteriography, CT-Angiography, Ultrasound-Colour Doppler, Contrast agent-intravenous, Diagnostic procedure, Embolisation, Acute, Blood, Haemorrhage
Learning objectives To review common and uncommon causes , as well as atypical presentations of Wunderlich Syndrome (WS). To present characteristic imaging appearances of WS in multimodality imaging techniques (US, CT-CTA, DSA) for guiding diagnosis and treatment in the Emergency Department (ED). To highlight the role of interventional radiology in the management of WS.
Read more Background Wunderlich syndrome (WS) is a rare , potentially fatal condition, characterized by spontaneous renal or perinephric hemorrhage, without history of known trauma. WS is named after the German physician Carl Reinhold August Wunderlich (1815-1877), who published the first clinical case, in 1856. [6]  The typical clinical presentation of WS consists of the classic Lenk's triad: acute flank pain, flank mass, and hypovolemic shock , although in clinical practice it is actually seen in only 20% of cases. However, clinical manifestations can be varied...
Read more Findings and procedure details We reviewed patients who admitted to the ED with spontaneous , non-traumatic, renal hemorrhage, in a University Hospital and referred for imaging and we present the most characteristic imaging appearances, due to common and uncommon causes.Clinical manifestation was acute, atypical, abdominal pain and an unexplained drop in Hemoglobin (Hb) and Hematocrit (Ht) levels. Angiomyolipomas (AMLs) : are a mesenchymal, bening neoplasm of the kidneys and one of the most common causes for WS. On CT, classic AMLs appear as heterogeneous masses...
Read more Conclusion Spontaneous , non-traumatic rupture of the kidney is a rare urological event , that may present with indolent , atypical symptoms. Awareness of WS in the ED and choosing the proper imaging modality is essential for diagnosis and patient’s management. Imaging – based embolization represents a promising and life-saving treatment method for patients with WS.
Read more References Wunderlich Syndrome: Comprehensive Review of Diagnosis and Management, Jignesh N. Shah, Darshan Gandhi et al, Radiographics, Published Online : May 25 2023, https://doi.org/10.1148/rg.220172 Wunderlich Syndrome Associated With Angiomyolipomas, David Antonio Ramirez-Limon, Nezahualcoyotl Gonzaga-Carlos et al, Cureus, Published: April 05, 2022, DOI: 10.7759/cureus.23861 Wunderlich's syndrome in a patient on hemodialysis with acquired cystic kidney disease. A report of a new case, J M Peña Porta , R Pernaute Lavilla, Actas Urol Esp 1999 Jan;23(1):76-8, PMID: 10089639 A Case of Spontaneous Renal Hemorrhage (Wunderlich Syndrome)...
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