Wunderlich Syndrome associated with Warfarin use
Keywords:
oral anticoagulant, nephrectomy, hematuriaAbstract
Introduction: Wunderlich syndrome is described as spontaneous renal hemorrhage or hemorrhage of non-traumatic origin. It is a rare and often fatal entity. Objective: To present a case of Wunderlich syndrome associated with the use of oral anticoagulants.
Objective: To present a case of Wunderlich syndrome associated with the use of oral anticoagulants.
Clinical case: A 77-year-old male patient with a personal pathological history of arterial hypertension, ischemic heart disease and atrial fibrillation treated with warfarin, without adequate control. The patient went to the emergency room with right lumbar pain of the colic type, of two days of evolution with irradiation to the right flank, iliac fossa and hemiscrotum, associated with hematuria, sweating and chills, without noting fever, and marked decay and general malaise. She denies a history of trauma and other urinary symptoms. Signs of hypovolemia associated with pain are observed.
Complementary tests are indicated where retroperitoneal hematoma is found in relation to Wunderlich syndrome. A conservative approach was maintained and as the general condition deteriorated, it was decided to perform emergency surgical treatment where, when addressing the retroperitoneal area, a perirenal hematoma was found in relation to the lower pole of the right kidney. A right nephrectomy was performed. In the histological study, no anatomical cause was defined. Conclusions: Wunderlich syndrome is a rare entity, but it can be fatal if not treated in a timely manner. Treatment depends on the patient's hemodynamic status.
Conclusions: Wunderlich syndrome is a rare entity, but it can be fatal if not treated in a timely manner. Treatment depends on the patient's hemodynamic status.
References
1. Sales R, Villa V, Caballé J, Mas A, Valencoso O, Ballús L, et al. Síndrome de Wünderlich. Hemorragia renal espontánea. Cir Esp [Internet]. 2000 [acceso: 11/08/2024]; 68 (5): 493-5. Disponible en: http://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-sindrome- wunderlich-hemorragia-renal-espontanea-13859
2. Segura Gortárez A, Barreda Pesqueira A, Segura Gortárez A, Barreda Pesqueira A. Síndrome de Wünderlich (hemorragia renal espontánea). Reporte de un caso. Rev Fac Med México [Internet]. 2021 [acceso: 11/08/2024]; 64 (6): 26-31. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_abstract&pid=S0026-17422021000600026&lng=es&nrm=iso&tlng=es
3. Pérez RP, Marichal FF, Molina EM, Peláez RP, Rodríguez CG, Barroso MO. Enfermedad de Wunderlich: comunicación de dos casos. Arch Méd Camagüey [Internet]. 2000[acceso: 11/08/2024]; 4 (4). Disponible en: https://revistaamc.sld.cu/index.php/amc/article/view/3602
4. Pastoriza RR, Gómez JLA, Martínez GRC. Rotura espontánea renal o Síndrome de Wünderlich. Rev Cuba Urol [Internet]. 2017 [acceso: 11/08/2024]; 6 (2): 121-6. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/304
5. Sánchez-Turati JG, Merayo-Chalico CE, Hernández-Castellanos VA, Saavedra Briones DV, Adrade Platas JD, Fernández Carreño AJ, et al. Síndrome de Wünderlich causado por angiomiolipoma renal de pequeñas dimensiones. Rev Mex Urol [Internet]. 2009 [acceso: 11/08/2024]; 69 (2): 75-8. Disponible en: http://www.elsevier.es/es-revista-revista- mexicana-urologia-302-articulo-sindrome-wunderlich-causado-por- angiomiolipoma-X2007408509495415
6. Wünderlich syndrome: a case report. An Sist Sanit Navar [Internet]. 2021 [acceso: 11/08/2024]; 44 (2): 311-3. Disponible en: https://recyt.fecyt.es/index.php/ASSN/article/view/86677/66205
7. Rey JR, García SL, Freire FD, Rodrigo AA, Iglesias BR, Calvo AO. Síndrome de Wünderlich: importancia del diagnóstico por imagen. Actas Urol Esp [Internet]. 2009 [acceso: 11/08/2024]; 33 (8): 917-9. Disponible en: https://www.sciencedirect.com/science/article/pii/S0210480609728827
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