Clinical Analysis of Spontaneous Renal Rupture with Perirenal Hemorrhage
신주위출혈을 동반한 신자연파열에 대한 임상적 분석
고, 동희; 김, 세중; 안, 현수
Taehan Pinyogikwa Hakhoe chi, 45(1):64-68, 2004
Taehan Pinyogikwa Hakhoe chi; The Korean journal of urology; 대한비뇨기과학회지
PURPOSE: Spontaneous renal rupture with perirenal hemorrhage is a relatively uncommon, but often diagnostically challenging, condition. Accurate diagnosis requires a combination of clinical information and radiological imaging. The etiology and clinical aspects of spontaneous renal rupture with perirenal hemorrhage were studied.
MATERIALS AND METHODS: Twelve cases(7 women and 5 men, mean age 44.5 years) of spontaneous renal rupture with perirenal hemorrhage in our hospital were retrospectively analyzed for symptoms, imaging studies, etiology, and treatment modalities. Twenty-five cases(15 women and 10 men, mean age 43.4 years) reported in Korea were also reviewed.
RESULTS: In our 12 cases, the etiology was neoplasm in 8(6 angiomyolipoma, 1 renal cell carcinoma, and 1 metastatic cancer), renal vascular disease in 3(2 arteriovenous malformation and 1 polyarteritis nodosa), and unidentified in 1. Radiologic studies(computed tomography and/or renal angiography) were done in all cases and 10(83.3%) were accurately diagnosed. Nephrectomy was performed in 5 cases, arterial embolization in 6, and conservative management in 1. In all 37 cases reported in Korea, including our own, neoplasm(26 cases, 70.3%) was the most common cause and angiomyolipoma(18 cases) was the leading cause. Computed tomography was performed in 33 cases, and 26 cases(78.8%) were correctly diagnosed. Nephrectomy was performed in 21 cases(56.8%).
CONCLUSIONS: The most common cause of spontaneous renal rupture with perirenal hemorrhage is angiomyolipoma. Computed tomography is the method of choice for the evaluation of spontaneous renal rupture with perirenal hemorrhage.
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