Spontaneous Renal Rupture

Spontaneous renal rupture is a rare complication during pregnancy. It can occur in three circumstances (Middleton et al. 1980): spontaneous rupture with no cause, rupture of the excretory tract related to an obstruction, and renal rupture secondary to a tumor, most often an angiomyolipoma. Clinically, the spontaneous rupture is manifested by lumbar or abdominal pain with thickening of the lumbar fossa and sometimes hemorrhagic shock. Ultrasound is a diagnostic aide that shows an effusion of urine around the kidney or a retroperitoneal hematoma. When there is rupture of the excretory tract related to obstruction, placing a double-J stent to remove the obstruction is the best approach (Oesterling et al. 1988). If this is not possible, percutaneous nephrostomy can be undertaken. Percutaneous drainage of a collection is sometimes necessary. When there is renal parenchyma rupture, strict monitoring is indispensable. Bleeding can stop spontaneously because of the pressure exerted on the retroperitoneum. When bleeding cannot be controlled and hemodynam-ics are unstable, open surgery is sometimes the only choice possible, with a nephrectomy often necessary.

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