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Acute Retroperitoneal Hemorrhage Induced by Giant Adrenal Myelolipoma Mimicking Renal Colic Pain: A Case Report

Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan
Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
Author to whom correspondence should be addressed.
Received: 1 March 2018 / Revised: 11 March 2018 / Accepted: 12 March 2018 / Published: 13 March 2018
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Retroperitoneal hemorrhage is a life-threatening clinical entity which is difficult to diagnose due to numerous etiology and unspecific symptoms. Spontaneous severe retroperitoneal hemorrhage, known as Wunderlich’s syndrome presented with Lenk’s triad, includes acute flank pain, flank mass, and hypovolemic shock. Giant adrenal myelolipoma causing Wunderlich’s syndrome is rare. Here, we presented a 59-year-old woman with spontaneous acute onset persistent left flank pain. The kidney, ureter, and bladder (KUB) study revealed left renal stones. The abnormal D-dimer level and progressive symptoms alerted emergency physicians to intervene timely. The computed tomography (CT) scan revealed a giant adrenal mass with retroperitoneal hemorrhage. After hemodynamically controlled and surgical intervention, she recovered and was followed up at the outpatient department (OPD). In this article, we highlight that myelolipoma-induced spontaneous retroperitoneal hemorrhage may cause Wunderlich’s syndrome and lead to hypovolemic shock. It is important for emergency physicians to intervene timely. Early diagnosis and management lead to a better outcome. View Full-Text
Keywords: adrenal myelolipoma; Wunderlich’s syndrome; Lenk’s triad adrenal myelolipoma; Wunderlich’s syndrome; Lenk’s triad

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Wu, M.-Y.; Hou, Y.-T.; Yiang, G.-T. Acute Retroperitoneal Hemorrhage Induced by Giant Adrenal Myelolipoma Mimicking Renal Colic Pain: A Case Report. Reports 2018, 1, 4.

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