CT EVALUATION OF UNDERLYING CAUSE IN SPONTANEOUS SUBCAPSULAR AND PERIRENAL HEMORRHAGE

We evaluated the CT scans of 13 patients with spontaneous subcapsular or perinephric hemorrhage (SPH) associated with these underlying cause s: 4 angiomyolipomas, 2 renal cell carcinomas, 1 renal metastatic mali gnant melanoma, 1 ruptured renal artery aneurysm, 1 adrenal myelolipom a, 1 ruptured renal abscess, 2 ruptured hemorrhagic cysts, and 1 patie nt with undiagnosed coagulation disorder. Our objective was to ascerta in whether an underlying cause of SPH was identifiable by CT, and to d etermine the extension of the hematomas. Computed tomography identifie d the hematoma in all 13 cases (sensitivity 100%). In all 12 cases in which there was a renal or adrenal anatomic lesion, the underlying cau se was identified with CT (100%), with correct diagnosis in 11 cases ( 91.6%). The case in which no lesion was identified was the undiagnosed coagulation disorder. We conclude that CT is a useful technique for t he initial evaluation of SPH, permitting diagnosis of hemorrhage and i dentification of the underlying cause.