{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T09:03:54Z","timestamp":1769850234003,"version":"3.49.0"},"reference-count":6,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,3]]},"published-print":{"date-parts":[[2019,5,17]]},"abstract":"<jats:p>Wunderlich\u2019s syndrome, non-traumatic renal haemorrhage into the subscapular and perinephric space, in pregnancy, is a very rare clinical entity. We describe a case of Wunderlich\u2019s syndrome in a 29-year-old gravida 5 para 4 who presented to our emergency department with sudden onset severe left flank pain. On assessment, she was clinically shocked\u2014hypotensive, tachycardic and perfused poorly peripherally. Ultrasound of the abdomen and pelvis and subsequent MRI of the left kidney revealed a large hypervascular exophytic lesion arising from the left renal pole\u2014appearance consistent with an angiomyolipoma. This specific presentation is clinically characterised as Lenk\u2019s triad\u2014acute flank pain, flank mass and hypovolaemic shock. The patient was adequately resuscitated and interventional radiological embolisation of the mass was performed. She went on to have an uneventful pregnancy and delivered vaginally after induction at 38 weeks of gestation.<\/jats:p>","DOI":"10.1136\/bcr-2019-229219","type":"journal-article","created":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T05:35:17Z","timestamp":1558330517000},"page":"e229219","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Wunderlich\u2019s syndrome in pregnancy: a shocking triad"],"prefix":"10.1136","volume":"12","author":[{"given":"Daniel","family":"Kane","sequence":"first","affiliation":[{"name":"Rotunda Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Abdelrahman","sequence":"additional","affiliation":[{"name":"Rotunda Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1323-9136","authenticated-orcid":false,"given":"Aisling T","family":"Looney","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Waterford, Waterford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maeve","family":"Eogan","sequence":"additional","affiliation":[{"name":"Rotunda Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,5,19]]},"reference":[{"key":"2025082711080051000_12.5.e229219.1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1933.01170020030002"},{"key":"2025082711080051000_12.5.e229219.2","first-page":"380","article-title":"tuberous sclerosis and pregnancy","volume":"77","author":"Illescas Molina","year":"2009","journal-title":"Ginecol Obstet Mex"},{"key":"2025082711080051000_12.5.e229219.3","unstructured":"EAU. EAU Guidelines. 2018 http:\/\/uroweb.org\/guideline\/renal-cell-carcinoma\/"},{"key":"2025082711080051000_12.5.e229219.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-004-1850-2"},{"key":"2025082711080051000_12.5.e229219.5","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4274\/tjod.32848","article-title":"Renal angiomyolipoma during pregnancy: Case report and literature review","volume":"12","author":"\u00c7etin","year":"2015","journal-title":"Turk J Obstet Gynecol"},{"key":"2025082711080051000_12.5.e229219.6","doi-asserted-by":"crossref","first-page":"203","DOI":"10.4103\/0974-2700.55346","article-title":"Wunderlich\u2019s syndrome and hemorrhagic shock","volume":"2","author":"Medda","year":"2009","journal-title":"J Emerg Trauma Shock"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:08:10Z","timestamp":1756318090000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,17]]},"references-count":6,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,19]]},"published-print":{"date-parts":[[2019,5,17]]}},"alternative-id":["10.1136\/bcr-2019-229219"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229219","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,17]]}}}