Department of Radiology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, USA. [email protected]
Spontaneous perirenal hemorrhage (SPH), also known as Wünderlich's syndrome, is a rare urological emergency. This article reviews the most common causes of SPH and the role of imaging in establishing the correct diagnosis and in guiding the appropriate therapy. A thorough understanding of underlying etiologies, imaging appearances, optimal imaging techniques, and follow-up protocols are crucial to recognize patients with SPH due to benign disease and avoid unnecessary nephrectomies.