[Etiology, diagnosis and management of spontaneous per renal hemorrhage].

Objective To investigate the etiology,diagnosis,and management of spontaneous perirenal hemorrhage(SPH).Methods The clinical data of 35 patients,10 males and 12 females,aged 35.9(12-77),with the diagnosis of SPH,without history of trauma,anticoagulant use,dialysis,and renal transplantation,were analyzed.Results The underlying disease of SPH included angiomyolipoma(18 cases),renal cell carcinoma(7 cases),kidney cyst(2 cases),renal artery aneurysm(3 cases),rupture of renal artery aneurysm accompanied with pregnancy(2 cases),renal pheochromocytoma(3 cases 2 of which accompanied with pregnancy),congenital stricture of pelviureter junction(1 case),and liver cancer(1 case).The most common underlying diseases were nephrigenic(96%) with angiomyolipoma ranking first(54%) followed by renal cell carcinoma(21%).The underlying diseases were diagnosed correctly in 23 cases(69%).CT helped in diagnosis of 34 cases.Surgery was performed on most of the cases.Conclusion The most common causes of SPH is renal neoplasms more than 50% of which are benign.Renal artery aneurysm and pheochromocytoma tend to rupture during pregnancy.CT is the first method of choice in diagnosis.