[Etiology, diagnosis and management of spontaneous per renal hemorrhage].
OBJECTIVE
To investigate the etiology, diagnosis, and management of spontaneous perirenal hemorrhage (SPH).


METHODS
The clinical data of 35 patients, 10 males and 12 females, aged 35.9 (12-77), with the diagnosis of SPH, without history of trauma, anticoagulant use, dialysis, and renal transplantation, were analyzed.


RESULTS
The underlying disease of SPH included angiomyolipoma (18 cases), renal cell carcinoma (7 cases), kidney cyst (2 cases), renal artery aneurysm (3 cases), rupture of renal artery aneurysm accompanied with pregnancy (2 cases), renal pheochromocytoma (3 cases 2 of which accompanied with pregnancy), congenital stricture of pelvic ureter junction (1 case), and liver cancer (1 case). The most common underlying diseases were nephrogenic (96%) with angiomyolipoma ranking first (54%) followed by renal cell carcinoma (21%). The underlying diseases were diagnosed correctly in 23 cases (69%). CT helped in diagnosis of 34 cases. Surgery was performed on most of the cases.


CONCLUSIONS
The most common causes of SPH is renal neoplasms more than 50% of which are benign. Renal artery aneurysm and pheochromocytoma tend to rupture during pregnancy. CT is the first method of choice in diagnosis.
Yu
Zhi-xian
ZX
Department of Urology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.
Xia
Guo-ping
GP
Hu
Wen-hao
WH
Chen
Wei
W
Li
Xiang-bin
XB
Chen
Hong-de
HD
Lin
Li-zhang
LZ
Deng
Zhe-xian
ZX
Cai
Bing
B
Weng
Zhi-liang
ZL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000150:complications; D015901:Angiography, Digital Subtraction; D018207:Angiomyolipoma / Q000150:complications; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D007680:Kidney Neoplasms / Q000150:complications; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012077:Renal Artery / Q000473:pathology; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000925:Anticoagulants