Acute abdomen and haemorrhagic shock caused by spontaneous renal cyst rupture in autosomal dominant polycystic kidney disease

Abstract

Autosomal dominant polycystic kidney disease is an important cause of chronic renal failure. Rarely, these patients may present with haemorrhagic shock caused by renal cyst rupture. The aim of this work was to report a rare case of a patient who arrived at the emergency department with autosomal dominant polycystic kidney disease presenting with acute abdominal pain and hemorrhagic shock. A 58 year old man with chronic renal failure was admitted to the emergency department with acute abdominal pain and haemorrhagic shock. The patient was admitted to the department of surgery with acute abdomen and perirenal haematoma. Although the patient was on conservative treatment, his symptoms did not improve and the patient was operated on. There was bleeding from the right polycystic kidney, which had a size of 30×20 cm during exploration. The patient underwent nephrectomy and drainage of the haematoma. The patient was discharged on the fifth postoperative day without any problems. Bleeding due to rupture of a cyst in autosomal dominant polycystic kidney disease occurs rarely but it may be life-threatening. Although conservative methods are often preferable for treatment, surgery can be life-saving for patients in whom the clinical situation does not improve. © Copyright 2013 by Turkish Surgical Association.