• Jiang Deng, He Huang, Jinhua Ma, Hongbing Wei, Xi Qu, Zheng Hu, Hui Zeng, and Jun Zhou.
• Hubei No. 3 People's Hospital of Jianghan University, Wuhan, China.
• Medicine (Baltimore). 2024 Jul 26; 103 (30): e39025e39025.

ObjectiveSpontaneous renal vessel rupture is a rare clinical emergency. However, pregnancy symptoms and signs are not obvious, and the limited examination methods obscure the observation. Thus, early renal rupture is challenging to detect, leading to misdiagnosis and poor prognosis. This paper aims to improve clinicians' understanding of this disease and reduce the rate of clinical misdiagnosis.Patient ConcernsThe patient, aged 23 and 11 weeks pregnant, developed severe right lumbar and abdominal pain for 14 hours after severe nausea, vomiting, and paroxysmal intensification. Color ultrasound of the urinary system at another hospital revealed right kidney stones and right ureter dilation. Thus, the patient came to our hospital for treatment.DiagnosesSpontaneous renal vessel rupture.InterventionsIn this case, the diagnosis of spontaneous renal vascular rupture and hemorrhage was confirmed. Following conservative treatment such as fluid replenishment, blood transfusion, and hemostasis, the patient was given an emergency renal artery embolization due to unstable hemodynamics during treatment and poor conservative treatment effect.OutcomesNephrectomy was performed after 1-week follow-up for renal necrosis.LessonsTo avoid missed diagnosis and misdiagnosis, patients with abdominal pain caused by severe vomiting during pregnancy must be closely monitored. Additionally, treatment should be considered individually to ensure the safety of both mother and child. Therefore, spontaneous renal vessel rupture should be considered as the differential diagnosis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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