RT Journal Article SR Electronic T1 Wunderlich’s syndrome in pregnancy: a shocking triad JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e229219 DO 10.1136/bcr-2019-229219 VO 12 IS 5 A1 Daniel Kane A1 Mona Abdelrahman A1 Aisling T Looney A1 Maeve Eogan YR 2019 UL http://casereports.bmj.com/content/12/5/e229219.abstract AB 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.