Zelaya Rainel, Byerly Douglas, Zarka Anthony
Radiology, San Antonio Uniformed Services Health Education Consortium, San Antonio, USA.
Radiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
Cureus. 2022 Apr 1;14(4):e23728. doi: 10.7759/cureus.23728. eCollection 2022 Apr.
Spontaneous suburothelial hemorrhage is a rare process of unclear pathologic etiology, although it has been associated with bleeding diathesis and anticoagulation. The most common clinical presentation is acute onset flank pain and macroscopic hematuria. On imaging, there is a mural thickening of the renal pelvis and upper ureters leading to luminal narrowing. Despite luminal narrowing, hydronephrosis has only rarely been reported in the association. The imaging finding of mural thickening has led to the misdiagnosis as malignancy, resulting in unnecessary nephrectomy. Suburothelial hemorrhage can be unilateral or bilateral, although the majority of reported cases are unilateral. We present a case of a patient with bilateral spontaneous suburothelial hemorrhage with forniceal rupture and spontaneous retroperitoneal hemorrhage, a unique triad compared to prior cases presented in the literature.
自发性膀胱黏膜下出血是一种病理病因不明的罕见病症，尽管它与出血素质和抗凝有关。最常见的临床表现是急性发作的胁腹痛和肉眼血尿。影像学检查显示肾盂和上段输尿管壁增厚，导致管腔狭窄。尽管管腔狭窄，但肾积水与这种情况相关的报道却很少。壁增厚的影像学表现导致误诊为恶性肿瘤，从而进行了不必要的肾切除术。膀胱黏膜下出血可为单侧或双侧，不过大多数报道的病例为单侧。我们报告一例双侧自发性膀胱黏膜下出血伴穹窿破裂和自发性腹膜后出血的患者，与文献中之前报道的病例相比，这是一种独特的三联征。
