Management of spontaneous subscapular renal hemorrhage: A multidisciplinary and hybrid approach to Wunderlich syndrome

Abstract

Wunderlich syndrome (WS), or spontaneous renal hemorrhage, is a rare and serious condition that demands prompt diagnosis and management. This report describes a 26-year-old female patient who experienced severe right-sided flank pain and hypovolemic symptoms during hemodialysis. The patient had several comorbidities, including poorly managed diabetes mellitus, diabetic nephropathy, and arterial hypertension. An active bleeding leading to a subcapsular renal hematoma was discovered by imaging. Using interventional radiology, immediate renal arterial embolization was part of the initial therapy. Recurrent bleeding required an emergency hemostatic nephrectomy despite temporary stabilization. This example emphasizes the importance of a hybrid management strategy that combines interventional radiology and surgical competence. It emphasizes how crucial a multidisciplinary team is to customizing interventions that strike a balance between the patient's underlying chronic comorbidities and the urgent requirements of a life-threatening illness. This all-encompassing strategy produced a favorable result.