Department of Urology, Tan Tock Seng Hospital, Singapore.
Can J Urol. 2020 Jun;27(3):10270-10272.
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.
Wunderlich 综合征（WS）是一种罕见的三联征，包括侧腹痛、侧腹部肿块和低血容量性休克，通常归因于血管平滑肌脂肪瘤或肿瘤。治疗方法取决于临床严重程度：保守治疗、选择性动脉栓塞或肾切除术。我们报告了一例 69 岁男性的非典型病例，他有一个 9 厘米大的左肾肿瘤，继发于抗凝治疗和对侧肾脏单纯性囊肿破裂，并发腹腔间隔室综合征，尽管给予了正性肌力支持和充分的复苏，但仍伴有血流动力学不稳定。早期识别和来源控制，通过根治性肾切除术，对于获得良好的结果至关重要。
