Wunderlich Syndrome, a rare cause of abdominal pain

Abstract

Resumo
A síndrome de Wunderlich é uma doença rara que se caracteriza por hemorragia espontânea nos espaços subcapsular e perirrenal. Apresentamos dois casos de síndrome de Wunderlich. Uma mulher de 38 anos com esclerose tuberosa que se apresentou com dor abdominal e hipotensão. A tomografia computadorizada (TC) revelou um hematoma peri-renal. Uma mulher de 86 anos, anticoagulada com varfarina por tromboembolismo pulmonar, apresentou-se com dor abdominal nos quadrantes inferiores. A TC abdominal revelou uma massa renal com hemorragia no espaço peri-renal. Foram ambas submetidas a embolização super-seletiva da artéria renal, com boa evolução posterior.

Abstract
Wunderlich syndrome is a rare disease characterized by spontaneous renal hemorrhage into the subcapsular and perirenal spaces. We report two cases of Wunderlich syndrome. A 38-year-old woman with tuberous sclerosis presented with abdominal pain and hypotension, perinephric hematoma was diagnosed by computerized tomography (CT) scan. A 86-year-old woman, treated with warfarin for pulmonary embolism, presented with abdominal pain in the lower quadrants. Abdominal CT scan revealed a renal mass with recent hemorrhage to perinephric space. Renal artery highly selective embolization was performed with good outcome in both cases.

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