Vol. 7, Issue 2, Part B (2025)

Wunderlich syndrome is a rare clinical entity. It is characterized by an acute onset of spontaneous hemorrhage into subcapsular, perirenal and/or pararenal spaces. Lenk triad (flank pain, flank mass and hypovolemic shock) which is classically associated with this condition is seen only in a small subset of cases. Common conditions leading to Wunderlich syndrome includes Renal neoplasms& Renal vascular anomalies. Other rare causes include Renal infections, cystic diseases, calculi, renal failure and coagulation disorders. Multiphasic CT & MRI imaging is used in better detection, localization and characterization of the underlying cause and facilitate optimal management. Imaging modalities like USG is used as follow up investigation. Treatment modalities include Conservative management, Arterial embolization and surgical procedures. In this article we are presenting a case of Acute pyelonephritis presenting as Wunderlich syndrome.