Severe pyonephrosis associated with spontaneous subcapsular renal hematoma

Non-traumatic spontaneous subcapsular renal hematoma, also known as Wunderlich syndrome, is a rare entity that is associated with some renal pathology, mainly tumors or cysts, anticoagulant drugs administration or unknown reasons. We present a case of an elderly patient that presented with spontaneous subcapsular renal hematoma and complete deterioration of his kidney due to severe pyonephrosis that was managed conservatively.