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J Korean Soc Emerg Med > Volume 12(4); 2001 > Article
Journal of The Korean Society of Emergency Medicine 2001;12(4): 523-527.
Idiopathic Spontaneous Renal Rupture
Jae Chol Yoon, Won Kim, Gyu Chong Cho, Jung Suck Hong, Mi Woo Lee, Sung Eun Jang, Se Hyun Oh, Kyoung Soo Lim
1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Korea. ddolddoli75@hanmail.net
2Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Korea.
3Department of Emergency Medicine, Kangnung Hospital, Korea.
ABSTRACT
Spontaneous renal rupture is a rare, but important, clinical problem that heralds a variety of kidney abnormalities. Tumors are the most common cause, followed by vascular disease, infection, nephritis and blood dyscrasia. In some cases, no underlying abnormality of the kidney can be found. The patients usually present with an acute onset of flank pain, a tender mass, and common symptoms and signs of shock. In most cases rapid surgical intervention is necessary and nephrectomy remains the treatment of choice in cases of a ruptured tumor. A 47 year-old female, who had been in good health previously, was hospitalized because of a sudden onset of left flank pain for one day. There was no history of trauma. Physical examination revealed marked tenderness and guarding over the left flank abdomen. A perirenal hematoma on the left side was seen with abdominal sonography. Computerized tomography demonstrated a large perirenal hematoma and a kidney rupture caudally. Selective renal angiography demonstrated an active bleeding over the lower pole, so a coil embolization and nephrectomy were performed. The histological examination of the kidney revealed no underlying abnormality. We report a case of idiopathic spontaneous renal rupture, along with a literature review.
Key words: Flank pain, Spontaneous renal rupture
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