Wünderlich sindrom kao prva manifestacija karcinoma bubrega – prikaz slučaja
| Autor: | Sanja Štifter, Melita Kukuljan, Dean Markić, Damir Miletić, Frano Marinelli |
|---|---|
| Jazyk: | chorvatština |
| Rok vydání: | 2018 |
| Předmět: |
abdominal pain
renal cancer Wünderlich syndrome Abdominal pain medicine.medical_specialty Angiomyolipoma medicine.medical_treatment Wünderlich sindrom Lumbar BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Urology Renal cell carcinoma abdominalna bol renalni karcinom medicine Pelvis business.industry General Medicine medicine.disease Nephrectomy medicine.anatomical_structure Wunderlich syndrome Abdomen Radiology medicine.symptom business BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Urologija abdominalni bol |
| Zdroj: | Medicina Fluminensis Volume 54 Issue 4 Medicina Fluminensis : Medicina Fluminensis |
| ISSN: | 1847-6864 1848-1868 1848-820X |
| DOI: | 10.21860/medflum2018_207363 |
| Popis: | Cilj: Prikazati spontano, netraumatsko perirenalno krvarenje (Wünderlich sindrom) kao prvu manifestaciju karcinoma bubrega te dijagnostički i terapijski postupak kod takvog bolesnika. Prikaz slučaja: Bolesnica stara 37 godina je došla na hitni medicinski trakt s intenzivnim, naglo nastalim bolovima u lijevom lumbalnom predjelu abdomena; uredno mokri, negira traumu i nema makrohematuriju. Zbog općeg lošeg stanja bolesnica je poslana na hitnu višeslojnu kompjuteriziranu tomografiju (Multi-slice computed tomography, MSCT) abdomena i zdjelice na kojoj je utvrđena inhomogena formacija u gornjem polu lijevog bubrega uz zaključak radiologa da se radi o perirenalnom krvarenju, najvjerojatnije uzrokovanog angiomiolipomom. Urolog se odlučio za hitni operacijski zahvat koji uključuje djelomičnu nefrektomiju lijevog bubrega te evakuaciju hematoma. Patohistološki pregled uputio je na karcinom bubrega kromofobnog tipa koji je uzrokovao krvarenje. Bolesnica se redovito kontrolira, nema znakova recidiva. Zaključak: Wünderlich sindrom je rijetka, potencijalno životno ugrožavajuća manifestacija karcinoma bubrega koja zahtijeva hitni operacijski zahvat. MSCT abdomena i zdjelice je radiološka metoda izbora za akutnu abdominalnu/lumbalnu bol u hemodinamski nestabilnog bolesnika. Aim: To present a case with spontaneous, non-traumatic, perirenal haemorrhage (Wünderlich syndrome) as a first manifestation of renal cell carcinoma. Case report: A 37-year-old female was admitted to the emergency unit with sudden and severe pain in the left lumbar area of abdomen. She has normal voiding, without macrohaematuria or trauma in her medical history. Because of her generally instable state she was referred to emergency multi-slice computed tomography (MSCT) exam of the abdomen and pelvis which reveals inhomogeneous mass in the upper pole of the left kidney. Radiology report indicated perirenal haemorrhage most likely caused by an angiomyolipoma. The patient was operated on by urologist who performed a partial nephrectomy of the left kidney and evacuation of haematoma. Samples were taken for histopathology and cromophobe renal cell carcinoma which caused the perirenal haemorrhage was diagnosed. Our patient is controlled on regular basis, without signs of tumour recurrence. Conclusion: Wünderlich syndrome as the first manifestation of renal cell carcinoma is a very rare but life-threatening manifestation of renal cancer that warrants urgent surgery. MSCT of the abdomen and pelvis is a method of choice in haemodynamically unstable patients with acute abdominal/lumbar pain. |
| Databáze: | OpenAIRE |
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