International Medical Case Reports Journal (Sep 2023)
Spontaneous Suburothelial Hemorrhage: The Crucial Role of Radiology in Preventing Unnecessary Interventions
Abstract
Amanuel Yegnanew Adela,1,2 Nebiyu Endrias Beshada,3 Adriano Basso Dias,4 Satheesh Krishna,4 Tesfaye Kebede1 1Radiology Department, Tikur Anbessa Specialized Referral Hospital (TASH), Addis Ababa University, Addis Ababa, Ethiopia; 2Radiology Department, Gondar University Specialized Comprehensive Referral Hospital, University of Gondar, Gondar, Amhara Regional State, Ethiopia; 3Radiology Department, Asela Referral and Teaching Hospital, Arsi University, Asela, Oromia Regional State, Ethiopia; 4Joint Department of Medical Imaging, University Medical Imaging Toronto; University Health Network–Mount Sinai Hospital–Women’s College Hospital, University of Toronto, Toronto, ON, CanadaCorrespondence: Amanuel Yegnanew Adela, 17179, Tel +251-918-26-1611, Email [email protected]; [email protected]: Spontaneous suburothelial hemorrhage (SSH), also known as Antopol Goldman lesion, is a rare condition characterized by spontaneous bleeding into the renal sinus and proximal ureter wall. This case report describes the clinical presentation, imaging findings, and management of SSH in a 20-year-old female initially suspected to have urothelial malignancy. Imaging features of SSH include pre-contrast hyperdensity and non-enhancing thickening of the pelviureteric wall, which can mimic transitional cell carcinoma (TCC) and lead to unnecessary interventions. Radiologists should maintain a high level of suspicion for SSH and be aware of its imaging characteristics to avoid misdiagnosis. Additionally, clinical data, such as bleeding dyscrasia, can aid in the imaging diagnosis. This report provides insights into the diagnosis and management of SSH while offering a comprehensive literature review on its clinical presentation and imaging features. Increased awareness of SSH will facilitate accurate diagnosis and appropriate management, avoiding unnecessary interventions for patients with this benign condition.Keywords: Antopol-Goldman lesion, hematuria, INR, non-contrast enhanced CT, SSH, spontaneous suburothelial hemorrhage
