Analysis of Clinical Misdiagnosis of Wunderlich Syndrome Caused by Renal Angiomyolipoma Rupture

XU Jingjing; DING Jun; LIU Junqiang

doi:10.3969/j.issn.1002-3429.2025.09.005

Abstract：Objective To explore the clinical features,diagnosis and treatment of Wunderlich syndrome caused by re-nal angiomyolipoma rupture,so as to reduce clinical misdiagnosis and mistreatment.Methods The clinical data of 3 patients with Wunderlich syndrome caused by renal angiomyolipoma rupture admitted from July 2021 to August 2023 were retrospectively analyzed,and the relevant literature was reviewed.Results One patient presented with pain on the left side of the waist and abdomen,nausea and vomiting,and was initially diagnosed as abdominal tumor rupture.Two patients presented with pain in the right lower back and abdomen,and the initial diagnosis was spontaneous renal rupture hemorrhage.All the lesions were unilater-al kidney,with 1 patient on the left side and 2 patients on the right side.All three patients were given anti-infection treatment,hemostasis and analgesia,including 2 patients receiving anti shock treatment,and their condition did not improve significantly.All abdominal contrast-enhanced CT examinations indicated renal angiomyolipoma rupture with massive hemorrhage.Surgical in-tervention was performed,including nephrectomy in 1 patient,and partial nephrectomy in 2 patients after renal artery emboliza-tion.Postoperative pathology confirmed the rupture of renal angiomyolipoma.The misdiagnosis lasted 1-3 d.The 3 patients were followed up for 1 year after operation and recovered well without recurrence.Conclusion Wunderlich syndrome caused by rup-ture of renal angiomyolipoma is rare and dangerous,requiring early diagnosis and treatment.The diagnosis and treatment of Wunderlich syndrome requires multidisciplinary consultation,and attention should be paid to the changes of early vital signs.The treatment strategy should be developed based on the severity of the condition and imaging diagnosis results to avoid delayed treatment.