Spontaneous rupture of hydronephrotic renal pelvis with massive hemorrhage.

Spontaneous rupture of a hydronephrotic renal pelvis with massive hemorrhage presents as a perplexing diagnostic challenge to the urologist. The preoperative distinction between this condition and spontaneous rupture of the kidney (Wunderlich disease) may prove uncertain or equivocal despite the application of exhaustive diagnostic modalities. Surgical intervention should follow initial stabilization, and nephrectomy has been the procedure of choice.