PMID: 15373169Sep 18, 2004Paper

Spontaneous renal haematoma: diagnostic and therapeutic approach in 7 cases

Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie
Francis DubosqBernard Gattegno

Abstract

Spontaneous renal haematomas are rare. The authors discuss the aetiological diagnosis and management of these haematomas. Seven cases (3 females and 4 males) of spontaneous renal haematoma were managed between July 1999 and December 2002 and the case files were studied retrospectively. The circumstances of discovery were nonspecific. One patient presented with haemorrhagic shock. Radiological work-up comprised abdominal ultrasound and CT scan in almost every case. Ultrasound failed to demonstrate the aetiological diagnosis. CT revealed the cause of bleeding in 7 cases. MRI was performed in 4 cases, but urgent angiography was not performed. Four total nephrectomies were necessary, while two patients were treated by conservative surgery. One patient was simply followed by repeat CT scan. The short-term course was favourable with a mean follow-up of 23 months. Spontaneous renal haematomas raise 2 problems, that of their aetiology: tumours are the commonest causes (angiomyolipoma and renal cell carcinoma), and that of their management. Three therapeutic approaches are possible: radical surgery in the case of uncontrollable bleeding, conservative surgery or surveillance in the absence of a life-threatening emergency and when the aet...Continue Reading

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