A case of Wunderlich syndrome in a postliver transplant patient

Wunderlich syndrome involves spontaneous renal hemorrhage into the subcapsular and perirenal spaces, often presenting with acute flank pain, a palpable mass, and shock. While commonly associated with native kidney tumors, it can also occur in transplant recipients, including rare cases in postliver transplant patients. We report the case of a 67-year-old man with a history of liver transplantation who developed spontaneous hemorrhage of the right kidney. Emergency surgery revealed a large retroperitoneal hematoma and a Grade IV renal injury. The patient recovered well after prompt surgical intervention. This case highlights the importance of considering Wunderlich syndrome in differential diagnoses for patients with acute abdominal symptoms and renal hemorrhage, regardless of transplant history. Early diagnosis and tailored management are key to preventing severe complications.