自發性腎臟出血併腎旁血腫是少見具潛在致命性的疾病，其主要的原因是腫瘤或血管病變。因腎膿瘍引起腎實質內動脈瘤更是罕見。傳統上處置常常僅是嚴密觀察，而全腎切除或部分腎切除是用於大量腎動脈出血或複雜腎內動脈瘤;現代醫療的進步，較不具侵襲性的血管栓塞術取代之。本篇病例報告一位糖尿病的69歲女性，續發於左腎膿瘍及腎實質內偽血管瘤的自發性腎臟出血，同時以敗血性及低容量性休克來表現。最初，病患接受標準加護照顧及抗生素治療成功地復甦後。再加上腎血管攝影術証實有多發血管瘤和一出血點，並以動脈栓塞術成功。病患保留她的腎臟併無其他合併症。

Spontaneous renal hemorrhage (SRH) with peri-renal hematoma is a rare and potentially fatal disease, and is mainly caused by neoplasm and vascular abnormalities. An intraparenchymal renal artery aneurysm (IPRAA) resulting from a renal abscess is even rarer. The traditional management of an IPRAA is simply close observation, and a nephrectomy or partial nephrectomy is reserved for overt renal artery rupture and complex intra-renal aneurysms. Recently, vascular embolization has become an effective alternative. In this report, we present a 69-year-old woman with diabetes with both septic and hypovolemic shock secondary to spontaneous renal hemorrhage due to a left renal abscess and IPRAA rupture. This patient was successfully resuscitated with standard intensive care and antibiotic treatment initially. Renal angiography demonstrated multiple aneurysms and an active bleeder which was subsequently occluded by intra-arterial embolization using micro-coils. The patient survived and her kidney was preserved without obvious complications.