Katabathina Venkata S, Katre Rashmi, Prasad Srinivasa R, Surabhi Venkateswar R, Shanbhogue Alampady K P, Sunnapwar Abhijit
Department of Radiology, University of Texas Health Science Center at San Antonio, TX 78229, USA.
J Comput Assist Tomogr. 2011 Jul-Aug;35(4):425-33. doi: 10.1097/RCT.0b013e3182203c5e.
Wunderlich syndrome (WS) is a rare condition characterized by acute onset of spontaneous, nontraumatic renal hemorrhage into the subcapsular and perirenal spaces. Wunderlich syndrome is classically characterized by the Lenk's triad: acute flank pain, flank mass, and hypovolemic shock. However, the clinical manifestations can be varied and nonspecific. A wide spectrum of neoplastic and nonneoplastic renal pathologies may result in WS. Renal neoplasms are the most common cause for WS, with angiomyolipoma being the most common benign neoplasm, whereas renal cell carcinoma is the most common malignant neoplasm. Other causative conditions of WS include vascular causes (vasculitis [polyarteritis nodosa being the most common cause], renal artery aneurysms, arteriovenous malformations and fistulas, and venous thrombosis), cystic renal diseases, renal infections, calculus disease, nephritis, and coagulation disorders. Cross-sectional imaging findings help in the detection of the subcapsular and/or perinephric hemorrhage and may identify underlying etiology. Renal angiography not only helps in diagnosis of the underlying cause in select cases but also allows control of active bleeding, which can avoid unnecessary emergent radical surgery.
温德利希综合征（WS）是一种罕见病症，其特征为自发性、非创伤性肾出血急性发作进入肾包膜下和肾周间隙。温德利希综合征的典型特征为伦克三联征：急性胁腹痛、胁腹肿块和低血容量性休克。然而，其临床表现可能多种多样且缺乏特异性。多种肿瘤性和非肿瘤性肾脏病变都可能导致WS。肾肿瘤是WS最常见的病因，其中血管平滑肌脂肪瘤是最常见的良性肿瘤，而肾细胞癌是最常见的恶性肿瘤。WS的其他致病因素包括血管性病因（血管炎[结节性多动脉炎是最常见病因]、肾动脉瘤、动静脉畸形和瘘管以及静脉血栓形成）、囊性肾病、肾脏感染、结石病、肾炎和凝血障碍。横断面成像检查结果有助于检测肾包膜下和/或肾周出血，并可能识别潜在病因。肾血管造影不仅有助于在特定病例中诊断潜在病因，还能控制活动性出血，从而避免不必要的急诊根治性手术。
