Rupture of renal angiomyolipoma with asymptomatic course in a patient with exacerbation of chronic pyelonephritis (clinical case)

Abstract

This research is devoted to the study and analysis of the clinical case of a patient with multiple bilateral angiomyolipoma of the kidneys. This tumor formation usually proceeds asymptomatically for several years. The causes include hereditary factor, hormonal failures, chronic inflammatory diseases of the genitourinary system. With a tumor growth of more than 5 cm, the risk of spontaneous rupture of the neoplasm wall with the development of retroperitoneal bleeding, which can turn into hemorrhagic shock, significantly increases. Diagnostics is performed by means of palpatory examination, ultrasound examination of the kidneys, computed tomography, magnetic resonance imaging, radiopaque angiography, biopsy with histological examination of tissues. In the absence of a detailed clinical picture, treatment is limited to observation, surgical treatment is carried out exclusively according to indications. With the combined asymptomatic course of angiomyolipoma with acute or chronic kidney diseases, a comprehensive laboratory and instrumental diagnosis is necessary at the early stages of the examination. There are rare cases when it is impossible to diagnose angiomyolipoma by the above methods, therefore it is necessary to conduct computed tomography or magnetic resonance imaging with contrast. In case of rupture of the tumor with the formation of a shock state, it is necessary to carry out resuscitation measures followed by emergency nephrectomy or resection of the kidney and further treatment of the patient in the intensive care unit.