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Spontaneous retroperitoneal hematoma – our experience with surgical approach


Authors: L. Mitáš 1;  T. Nevrtal 1;  L. Kunovsky 1,2;  Z. Kala 1;  J. Kamelander 3;  V. Čan 1;  T. Andrašina 4 ;  M. Penka 3;  I. Penka 1
Authors place of work: Chirurgická klinika, Fakultní nemocnice Brno, Lékařská fakulta Masarykovy univerzity 1;  Interní gastroenterologická klinika, Fakultní nemocnice Brno, Lékařská fakulta Masarykovy univerzity 2;  Oddělení klinické hematologie, Fakultní nemocnice Brno, Lékařská fakulta Masarykovy univerzity 3;  Klinika radiologie a nukleární medicíny, Fakultní nemocnice Brno, Lékařská fakulta Masarykovy univerzity 4
Published in the journal: Rozhl. Chir., 2019, roč. 98, č. 1, s. 23-26.
Category: Kazuistika

Summary

Spontaneous retroperitoneal hematoma is a serious complication of anticoagulation and antiplatelet therapy. Its incidence has increased in recent years due to an increasing number of patients on this treatment. A number of case series have been described in the literature. In the vast majority of cases, the hemodynamically stable patients were treated either conservatively or by selective radiological embolization of the bleeding source. A surgical approach is reported as a last choice in the cases where the conservative therapy fails, radiological intervention is unavailable, in patients with continuous bleeding or in patients who develop abdominal compartment syndrome.

In our case report, we present a patient on anticoagulation therapy for deep venous thrombosis complicated by massive retroperitoneal bleeding: surgery was used as the method of first choice and the treatment was successful.

Key words:

retroperitoneal hematoma − bleeding − anticoagulation treatment − surgery


Zdroje
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  3. Ernits M, Mohan PS, Fares LG, et al. A retro­peritoneal bleed induced by enoxaparin therapy. Am Surg 2005;71:430–3.

  4. Chan YC, Morales JP, Reidy JF, et al. Mana­gement of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract 2008;62:1604–13.

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  11. Butt MU, Buzsaki LA, Smyth SS, et al. Deep vein thrombosis complicated by spontaneous iliopsoas hematoma in patient with septic shock. Am J Case Rep 2017;18:1148–52.

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  14. Triscott J, Mercer S, Tian PG, et al. Retroperitoneal haematoma associated with enoxaparin use in an elderly woman with chronic kidney disease. BMJ Case Rep 2015. Available from: doi:10.1136/bcr-2015-211699.

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Štítky
Chirurgie všeobecná Ortopedie Urgentní medicína

Článek vyšel v časopise

Rozhledy v chirurgii

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2019 Číslo 1
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