ETIOLOGY, DIAGNOSIS AND MANAGEMENT OF SPONTANEOUS PERIRENAL HEMATOMAS

This study focuses on the diagnostic and therapeutic challenge posed b y spontaneous perirenal haematomas (SPHs). The medical records of 18 p atients with SPHs seen in the past 8 years were reviewed with respect to aetiology, diagnosis and therapeutic management. SPH was secondary to angiomyolipoma (n = 4), polycystic kidneys (n = 4), panarteritis no dosa (n = 3), renal cell carcinomas (RCCs, n = 2), glomerulonephritis, pyelonephritis, Morbus Wegener and cortical adenoma (one each). One c ase remained unclear. With appropriate imaging techniques (computed to mography and angiography) the underlying disorder was detected in 72%; in 4 cases the diagnosis was revealed by exploration and biopsy. Surg ery was necessary in 16 patients. The cause of bleeding can be reveale d by appropriate imaging in most cases. When imaging procedures fail t o reveal the cause of SPH, exploration and biopsy are mandatory to exc lude RCC. If the cause of SPH remains unclear even after exploration, patient monitoring by CT is justified.