EURORAD ESR

Case 12205

A case of Wünderlich syndrome

Author(s)
Rebeca Mirón Mombiela, Pilar Moreno Granero.

Hospital General Universitario de Valencia, Spain.
Email:mirona@ufm.edu
 
Patient
male, 73 year(s)
 
 
  • Figure 1
    Ultrasound

    A. Left kidney ultrasound of the patient performed in 2013. B. Current ultrasound of the same kidney, showing hyperechoic lesion (arrow) and severe morphologic changes.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Blood;
     
     
  • Figure 2
    CT images
     

    Venous phase axial CT where subcapsular haematoma of the left kidney is seen with retroperitoneal haematoma.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Blood;

    Venous phase coronal CT where subcapsular haematoma of the left kidney is seen with retroperitoneal haematoma.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Blood;

    Venous phase axial CT where active bleeding (arrow) was detected in the left kidney.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Blood;

    Venous phase coronal CT where active bleeding (arrow) was detected in the left kidney.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Blood;
     
     
  • Figure 3
    Abdominal angiography

    Abdominal angiography shows extensive arteriosclerosis of the abdominal arteries, including the left kidney artery which bleeds in this patient.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Blood;
     
     
  • Figure 4
    Left renal artery angiography
     

    Digital substraction angiography of the left renal artery shows altered morphology of the left kidney (Fig. 4 a-c).

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Blood;

    Digital substraction angiography of the left renal artery shows altered morphology of the left kidney (Fig. 4 a-c).

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Blood;

    Digital substraction angiography of the left renal artery shows altered morphology of the left kidney with contrast media release into the renal parenchyma and active bleeding in several sites (Fig. 4 c-d).

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Blood;

    Digital substraction angiography of the left renal artery shows altered morphology of the left kidney with contrast media release into the renal parenchyma and active bleeding in several sites (Fig. 4 c-d).

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Blood;

    Digital substraction angiography of the left renal artery after selective embolization with PVA.

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Blood;
     
     
A. Left kidney ultrasound of the patient performed in 2013. B. Current ultrasound of the same kidney, showing hyperechoic lesion (arrow) and severe morphologic changes.
 
Venous phase axial CT where subcapsular haematoma of the left kidney is seen with retroperitoneal haematoma.
 
Venous phase coronal CT where subcapsular haematoma of the left kidney is seen with retroperitoneal haematoma.
 
Venous phase axial CT where active bleeding (arrow) was detected in the left kidney.
 
Venous phase coronal CT where active bleeding (arrow) was detected in the left kidney.
 
Abdominal angiography shows extensive arteriosclerosis of the abdominal arteries, including the left kidney artery which bleeds in this patient.
 
Digital substraction angiography of the left renal artery shows altered morphology of the left kidney (Fig. 4 a-c).
 
Digital substraction angiography of the left renal artery shows altered morphology of the left kidney (Fig. 4 a-c).
 
Digital substraction angiography of the left renal artery shows altered morphology of the left kidney with contrast media release into the renal parenchyma and active bleeding in several sites (Fig. 4 c-d).
 
Digital substraction angiography of the left renal artery shows altered morphology of the left kidney with contrast media release into the renal parenchyma and active bleeding in several sites (Fig. 4 c-d).
 
Digital substraction angiography of the left renal artery after selective embolization with PVA.
 
 
 
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