Bilateral spontaneous perinephric hematoma.

A 55-year-old man presented with a history of generalized swelling all over the body and uremic symptoms. Physical examination revealed pallor, anasarca, and hypertension. A gradual elevation of serum creatinine level from 1.6 mg/dL to 6.49 mg/dL was documented within 3 weeks. Urinalysis did not show any abnormal sign. Ultrasonography revealed the right kidney sized 9.5 × 3 cm and the left kidney, 10 × 4.9 cm, with large bilateral perinephric collections. Doppler ultrasonography revealed a 1.3-cm midpole aneurysm in the right kidney and multiple left renal aneurysms. Computed tomography revealed heterogeneous bilateral collections with fascial thickening in the perirenal spaces suggestive of bilateral perirenal hematomas with bilateral renal artery aneurysms. He was subjected to bilateral renal angiography and coiling of the aneurysms. Perinephric collection was evacuated by flank incision. Subcapsular renal hematomas occur secondary to variable etiologies and Page kidney phenomenon can lead to kidney failure.(1) When occurs unilaterally, it can be managed expectantly, but Page kidney in a solitary unit or bilateral Page kidney can lead to acute kidney failure, necessitating intervention to avoid the irreversible kidney damage.(2)