Abstract
Wunderlich syndrome (WS), characterized by spontaneous nontraumatic renal or perinephric hemorrhage, presents a significant diagnostic challenge due to its varied causes and clinical manifestations. Despite its historically high case fatality rate, prompt and accurate diagnosis combined with a multidisciplinary treatment approach has been shown to significantly improve patient outcomes. This case series discusses three patients with diverse presentations of WS, each managed with tailored therapeutic strategies involving a combination of conservative management, super selective renal artery embolization, and surgical interventions such as nephrectomy. The successful outcomes in these cases underscore the importance of high clinical suspicion, early diagnosis, and comprehensive management to mitigate the syndrome's potentially fatal consequences. Subcapsular hematomas, typically self-limiting, highlight the role of conservative management in renal preservation. This series reinforces that timely and appropriate intervention can transform the prognosis of WS from lethal to manageable.