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Wunderlich’s syndrome in pregnancy: a shocking triad
  1. Daniel Kane1,
  2. Mona Abdelrahman1,
  3. Aisling T Looney2 and
  4. Maeve Eogan1
  1. 1 Rotunda Hospital, Dublin, Ireland
  2. 2 Department of Urology, University Hospital Waterford, Waterford, Ireland
  1. Correspondence to Dr Daniel Kane, danielkane{at}


Wunderlich’s syndrome, non-traumatic renal haemorrhage into the subscapular and perinephric space, in pregnancy, is a very rare clinical entity. We describe a case of Wunderlich’s syndrome in a 29-year-old gravida 5 para 4 who presented to our emergency department with sudden onset severe left flank pain. On assessment, she was clinically shocked—hypotensive, tachycardic and perfused poorly peripherally. Ultrasound of the abdomen and pelvis and subsequent MRI of the left kidney revealed a large hypervascular exophytic lesion arising from the left renal pole—appearance consistent with an angiomyolipoma. This specific presentation is clinically characterised as Lenk’s triad—acute flank pain, flank mass and hypovolaemic shock. The patient was adequately resuscitated and interventional radiological embolisation of the mass was performed. She went on to have an uneventful pregnancy and delivered vaginally after induction at 38 weeks of gestation.

  • obstetrics and gynaecology
  • urology

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  • Contributors DK—author/obstetrics team—involved in patient’s care. MA—second author/obstetrics team—involved in patient’s care. ATL—third author and urologist—involved in patient care. ME—consultant obstetrician—involved in patient’s care.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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