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April 27, 1979

Fatal Retroperitoneal HemorrhageAn Unusual Complication of Renal Cortical Abscess

Author Affiliations

From the Departments of Medicine (Drs Murray and Soave) and Pathology (Dr Collins), The New York Hospital.

JAMA. 1979;241(17):1823-1824. doi:10.1001/jama.1979.03290430041022

RENAL cortical abscess (renal carbuncle) is an uncommon disorder that may be associated with a variety of clinical and pathological complications. These have included perforation (with or without fistula formation) into contiguous areas such as the peritoneal cavity, perinephric space, and renal pelvis.1 Peritonitis, perinephric abscess, and urinary tract infection or obstruction may follow. Chronic renal cortical abscess may also closely mimic renal neoplasms and occasionally be responsible for prolonged fever of unknown origin.

Recently, we cared for a patient with a renal cortical abscess in whom a massive retroperitoneal hemorrhage developed. Bleeding appeared to result from abscess erosion into the renal vasculature. This case illustrates an unusual and catastrophic complication of a visceral abscess.

Report of a Case  A 42-year-old alcoholic woman was hospitalized because of one day of severe right upper quadrant pain and abrupt abdominal distension. She was acutely ill and tachypneic. The blood pressure was