Spontaneous subcapsular hematoma of the kidney due to renal colic: a case report and analysis of causes

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Resumo

Renal colic is characterized by acute pain in the lower back. The most common cause of this condition is a stone blocking the outflow of urine from the kidney. Long-term obstruction leads to hypertension of the renal pelvis, which leads to the development of urinoma, is the cause of rupture of the renal pelvis, and in rarer cases to bleeding with stages of subcapsular hematoma.

The article presents a case of a 51-year-old patient who was admitted with complaints of intense pain in the lumbar region on the left. The anamnesis included repeated attacks of renal colic, acquired independently. Computed tomography revealed a subcapsular fluid accumulation measuring 50×80 mm, probably hematoma. Ultrasound examination confirmed the presence of a subcapsular hematoma. The patient underwent drainage of the upper urinary tract with a ureteral stent. The postoperative period was without surgery. Currently, regression of the subcapsular hematoma is observed.

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Sobre autores

Magomed Asadulaev

Institute of Urology and Reproductive Health of the Sechenov First Moscow State Medical University

Autor responsável pela correspondência
Email: asadulaev007@mail.ru
ORCID ID: 0009-0002-3159-692X

Postgraduate Student

Rússia, Bldg. 1, 2, Bolshaya Pirogovskaya St., Moscow, 119435

Mikhail Enikeev

Institute of Urology and Reproductive Health of the Sechenov First Moscow State Medical University

Email: enikmic@mail.ru
ORCID ID: 0000-0002-3007-1315

Dr. Sc. (Med.), Professor

Rússia, Bldg. 1, 2, Bolshaya Pirogovskaya St., Moscow, 119435

Magomed Gazimiev

Institute of Urology and Reproductive Health of the Sechenov First Moscow State Medical University

Email: gazimiev_m_a@staff.sechenov.ru
ORCID ID: 0000-0002-8398-1865

Dr. Sc. (Med.), Professor, Director of Academic and Educational Work

Rússia, Bldg. 1, 2, Bolshaya Pirogovskaya St., Moscow, 119435

Abdusalam Abdusalamov

Institute of Urology and Reproductive Health of the Sechenov First Moscow State Medical University

Email: boss4673@mail.ru

Cand. Sc. (Med.), Urologist at the 2nd Urology Department

Rússia, Bldg. 1, 2, Bolshaya Pirogovskaya St., Moscow, 119435

Dmitry Korolev

Institute of Urology and Reproductive Health of the Sechenov First Moscow State Medical University

Email: demix84@inbox.ru
ORCID ID: 0000-0001-8861-8187

Cand. Sc. (Med.), Associate Professor

Rússia, Bldg. 1, 2, Bolshaya Pirogovskaya St., Moscow, 119435

Victoria Rodionova

Sklifosovsky Institute of Clinical Medicine of the Sechenov First Moscow State Medical University

Email: rodionchik2002@mail.ru

4th-Year Student

Rússia, Bldg. 2, 11, Rossolimo St., Moscow, 119021

Leonid Rapoport

Institute of Urology and Reproductive Health of the Sechenov First Moscow State Medical University

Email: rapoport_l_m@staff.sechenov.ru
ORCID ID: 0000-0001-7787-1240

Dr. Sc. (Med.), Professor, Deputy Medical Director

Rússia, Bldg. 1, 2, Bolshaya Pirogovskaya St., Moscow, 119435

Bibliografia

  1. Hyams ES, Korley FK, Pham JC, Matlaga BR. Trends in imaging use during the emergency department evaluation of flank pain. J Urol. 2011 Dec;186(6):2270-4. doi: 10.1016/j.juro.2011.07.079. Epub 2011 Oct 20. PMID: 22014815.
  2. Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, Roehrborn CG, Kryger JV, Nakada SY. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol. 1998 Oct;160(4):1260-4. PMID: 9751331.
  3. Gershman B, Kulkarni N, Sahani DV, Eisner BH. Causes of renal forniceal rupture. BJU Int. 2011 Dec;108(11):1909-11; discussion 1912. doi: 10.1111/j.1464-410X.2011.10164.x. Epub 2011 Jul 8. PMID: 21736690.
  4. Belville JS, Morgentaler A, Loughlin KR, Tumeh SS. Spontaneous perinephric and subcapsular renal hemorrhage: evaluation with CT, US, and angiography. Radiology. 1989 Sep;172(3):733-8. doi: 10.1148/radiology.172.3.2672096. PMID: 2672096.
  5. Petros FG, Zynger DL, Box GN, Shah KK. Perinephric Hematoma and Hemorrhagic Shock as a Rare Presentation for an Acutely Obstructive Ureteral Stone with Forniceal Rupture: A Case Report. J Endourol Case Rep. 2016 Apr 1;2(1):74-7. doi: 10.1089/cren.2016.0033. PMID: 27579423; PMCID: PMC4996598.
  6. Alyayev Yu.G., Akopyan G.N. Spontaneous Kidney Rupture: Monograph. Moscow: MGOU Publishing House, 2010. 156 p. ISBN 978-5-7045-0931-1. Russian (Аляев Ю.Г., Акопян Г.Н. Спонтанный разрыв почки: монография. Москва: Изд-во МГОУ, 2010. 156 с. ISBN 978-5-7045-0931-1).
  7. Sampaio FJB, Mandarim-de-Lacerda CA. Anatomic classification of the kidney collecting system for endourologic procedures. J Endourol. 1988;2:247-51
  8. Ufuk F, Demirci M, Özlülerden Y, Çelen S. An Unusual Complication of Urinary Stone Disease: Spontaneous Perirenal Hematoma. J Emerg Med. 2019 Dec;57(6):e191-e192. doi: 10.1016/j.jemermed.2019.08.006. Epub 2019 Oct 8. PMID: 31604591.

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2. Fig. 1. CT scan of the abdominal organs (excretory phase): A) frontal projection image – subcapsular fluid accumulation along the posterior contour of the kidney (marked with arrows); B) axial projection image

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3. Fig. 2. Control CT scan of the abdominal organs (excretory phase): A) frontal projection image – no haematoma; B) axial projection image

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4. Fig. 3. Comparison of CT image of the left kidney of the patient (Fig. A) with polyester cast of the left kidney of group B, type B-I according to Francisco J. Sampaio [6] (Fig. B)

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