Spontaneous Subcapsular Renal Haematoma : A Case Report

Spontaneous subcapsular renal haematoma is a rare condition with wide range of presentation; it poses a dilemma for diagnosis and management. We present a case of 38-year-old female who presented with right flank pain (continuous, dull aching) for a week with right renal angle tenderness and high blood pressure (though she was not known hypertensive). On imaging, there was right renal subcapsular collection. She did not respond to conservative management except that her blood pressure was controlled with single drug Angiotensin Converting Enzyme (ACE) inhibitor. Right double J stent was placed (in view of urinoma) and patient was followed for six weeks. Repeat computed tomography scan showed persistence of right renal subcapsular collection but the cause was not found. Except hypertension, no definitive cause for the condition could be found. Patient was intervened surgically with right subcostal exploration and subcapsular haematoma was found and drained. Patient was asymptomatic thereafter.