Keywords
Isolated flank pain
Emergency medicine
Hemorrhagic shock
Renal angiomyolipoma
Categories
How to Cite
Abstract
Introduction: Ruptured renal angiomyolipoma (AML) is a life-threatening condition that may mimic other diagnoses in the clinical presentation, and if not diagnosed promptly, it can lead to life-threatening bleeding and shock. Case Report: In this article, we report the case of a 56-year-old previously healthy Saudi man who presented with isolated left flank pain. The patient was initially treated as a case of renal colic, possibly caused by renal stones. However, the imaging revealed the clinical picture to be caused by a ruptured renal AML of the left kidney and successfully treated with angiographic embolization by an interventional radiologist. Conclusion: Despite its rare occurrence, rupture of the renal AML may mimic other diagnoses and lead to life-threatening hemorrhagic shock. Prompt diagnosis and management can improve outcomes. By reporting this case, we want to highlight the importance of considering alternative differential diagnoses and including all the substantial life-threatening conditions while dealing with patients presenting with isolated flank pain, even with no other risk factor.
References
Tahat, R. Renal angiomyolipoma with spontaneous rupture. Case study, Radiopaedia.org. Accessed on 29 May 2022. https://doi.org/10.53347/rID-80927
Fujii Y, Ajima J, Oka K, Tosaka A, Takehara Y. Benign renal tumors detected among healthy adults by abdominal ultrasonography. Eur Urol. 1995;27(2):124-7. https://doi.org/10.1159/000475142
Flum AS, Hamoui N, Said MA, Yang XJ, Casalino DD, McGuire BB, Perry KT, Nadler RB. Update on the Diagnosis and Management of Renal Angiomyolipoma. J Urol. 2016 Apr;195(4 Pt 1):834-46. https://doi.org/10.1016/j.juro.2015.07.126
Chronopoulos PN, Kaisidis GN, Vaiopoulos CK, Perits DM, Varvarousis MN, Malioris AV, Pazarli E, Skandalos IK. Spontaneous rupture of a giant renal angiomyolipoma-Wunderlich's syndrome: Report of a case. Int J Surg Case Rep. 2016;19:140-3. https://doi.org/10.1016/j.ijscr.2015.12.017
Vos N, Oyen R. Renal Angiomyolipoma: The Good, the Bad, and the Ugly. Journal of the Belgian Society of Radiology. 2018;102(1):41. http://doi.org/10.5334/jbsr.1536
Fittschen, A, Wendlik, I, Oeztuerk, S, et al. Prevalence of sporadic renal Angiomyolipoma: A retrospective analysis of 61,389 in- and out-patients. Abdom Imaging. 2014;39(5):1009–1013. https://doi.org/10.1007/s00261-014-0129-6
Nelson CP, Sanda MG. Contemporary diagnosis and management of renal Angiomyolipoma. J Urol. 2002 Oct;168(4 Pt 1):1315-25. https://doi.org/10.1097/01.ju.0000028200.86216.b2
Oesterling JE, Fishman EK, Goldman SM, Marshall FF. The management of renal Angiomyolipoma. J Urol. 1986 Jun;135(6):1121-4. https://doi.org/10.1016/s0022-5347(17)46013-7
Simmons JL, Hussain SA, Riley P, Wallace DM. Management of renal Angiomyolipoma in patients with tuberous sclerosis complex. Oncol Rep. 2003 Jan-Feb;10(1):237-41.
Kim JW, Kim JY, Ahn ST, Park TY, Oh MM, Moon DG, et al. Spontaneous perirenal hemorrhage (Wunderlich syndrome): An analysis of 28 cases. Am J Emerg Med [Internet]. 2019;37(1):45–7. http://dx.doi.org/10.1016/j.ajem.2018.04.045
Xu X-F, Hu X-H, Zuo Q-M, Zhang J, Xu H-Y, Zhang Y. A scoring system based on clinical features for the prediction of sporadic renal angiomyolipoma rupture and hemorrhage. Medicine. 2020;99(20):e20167. http://dx.doi.org/10.1097/MD.0000000000020167
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Alshiakh S.
