Spontaneous Subcapsular Renal Haematoma in Adolescents: Report of Two Cases

Introduction: Spontaneous subcapsular renal hematoma in adolescence is a rare. The pathological finding is bleeding between the parenchyma and the intact kidney capsule. There is no history of trauma, blood or blood vessel diseases, or taking anticoagulant therapy.

Case Presentation:

Patient 1: Twelve year old girl suffered a pain in the right lumbar region. The ultrasonographic examination revealed 10 mm subcapsular hematoma on the right kidney, the left one was normal. The trauma and other diseases were excluded as the cause of bleeding. Haematoma descreased in next few months and was completely absorbed after six months. Eight years follow up presented excellent genetal condition.

Patient 2: Fifteen years old boy was experienced a sudden very severe pain in the left lumbar region at rest time. He was admitted at emergency depatrment and renal sonography revealed 20 mm subcapsular bleeding on the left kidney, the right one was as normal as other organs in abdominal compartment. Next month haematoma increased up to 25 mm. Trauma was excluded as a cause. Laboratory screning, CT and MR imaging didn’t find the cause of haemorrhage. Therapy were “bed and rest” and antibiotic four weeks. Resorption of hematoma was very slow in next months and after a year it completely disappeared. Ten years later all morphological and biochemical tests of the both kidney are satisfied.

Conclusion: A conservative treatment should be prefered in the adolescent period for spontaneous subcapsular renal hematoma. Parents and patients are advised to continue regular monitoring of kidney status and function, general condition and arterial pressure.

Keywords: subcapsular renal hematoma, spontaneous, adolescent, conservative approach.