Spontaneous perirenal hemorrhage (Wunderlich syndrome) in the fetus: a case report

J Med Case Rep. 2023 May 6;17(1):204. doi: 10.1186/s13256-023-03867-4.

Abstract

Background: Spontaneous perirenal hemorrhage (Wunderlich syndrome) in the fetus is a rare urinary system disease. Prenatal ultrasound diagnosis presents challenges due to the lack of specific clinical features.

Case presentation: A 27-year-old Chinese woman gravida 2 para 0 found her fetus with the left Wunderlich syndrome accompanying bilateral hydronephroses and bladder dysfunction with an early diagnosis through prenatal ultrasound and postnatal magnetic resonance imaging. After a timely emergency cesarean section, the infant was administrated antimicrobial prophylaxis and an indwelling catheter treatment. Ultrasound follow-up showed his urinary system gradually developed normally.

Conclusion: A fetus with bilateral hydronephroses accompanying bladder dysfunction should be observed because of the risk of spontaneous renal rupture with hemorrhage formation. Ultrasound and magnetic resonance imaging play a vital role in the diagnosis and follow-up of Wunderlich syndrome. Early diagnosis facilitates better pregnancy planning and appropriate care of newborns.

Keywords: Bladder dysfunction; Hydronephroses; Spontaneous perirenal hemorrhage; Ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple*
  • Adult
  • Cesarean Section / adverse effects
  • Female
  • Fetus / pathology
  • Hemorrhage / diagnostic imaging
  • Hemorrhage / etiology
  • Humans
  • Hydronephrosis*
  • Infant, Newborn
  • Kidney Diseases* / diagnosis
  • Pregnancy

Supplementary concepts

  • Uterine Anomalies