[Spontaneous kidney parenchymal rupture--etiology, symptoms, diagnosis and therapy].

Spontaneous rupture of the renal parenchyma with perirenal hematoma occurs rarely. A review was made of 85 cases published in the literature, including 2 of our own. Tumors were the most common cause followed by vascular diseases of the kidney. The most common symptoms were an acute onset of flank or abdominal pain (65%), microscopic or macroscopic hematuria (43%) and signs of hemorrhagic shock (33%). In all cases a tender flank and/or mass were palpable. Urography reveals a mass, distorted collecting system and/or non-visualization of the kidney. Nephrectomy when possible should be performed expeditiously since conservative therapy is uniformly unsuccessful and life-threatening.