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RESIDENT’S CORNER

Wunderlich syndrome secondary to cyst rupture and concurrent anticoagulation

Clarissa M. Gurbani¹, Vincent Khor², Jeffrey J. Leow¹, Melissa H.W. Tay³, Yew-Lam Chong¹

1 Department of Urology, Tan Tock Seng Hospital, Singapore
2 Department of Urology, Hospital Pengajar Universiti Putra Malaysia
3 Department of Urology, National University Hospital, Singapore
Address correspondence to Dr. Clarissa M. Gurbani, Department of Urology, Tan Tock Seng Hospital, Singapore

Canadian Journal of Urology 2020, 27(3), 10270-10272.

Abstract

Wunderlich syndrome (WS) is a rare triad of flank pain, flank mass and hypovolemic shock and is classically attributed to angiomyolipomata or neoplasms. Treatment is guided by clinical severity: conservative, selective arterial embolization, or nephrectomy. We report an atypical case of a 69-year old man with a pre-existing 9 cm left renal tumor who developed WS secondary to anticoagulation and simple cyst rupture from his contralateral kidney, complicated by abdominal compartment syndrome with hemodynamic instability despite inotropic support and robust resuscitation. Early recognition and source control via radical nephrectomy were essential in securing a positive outcome.

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Keywords

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