Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents  

作　　者：Wen-xing FAN Zheng-xu DENG Fang LIU Rong-bo LIU Ling HE Bogati AMRIT Li ZANG Jing-wen LI Xian-rong LIU Song-min HUANG Ping FU 

机构地区：[1]Department of Nephrology,West China Hospital,Sichuan University,Chengdu 610041,China [2]Department of Radiology,West China Hospital Sichuan University,Chengdu 610041,China

出　　处：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》2012年第5期408-412,共5页浙江大学学报（英文版）B辑（生物医学与生物技术）

摘　　要：In this paper, we described the symptoms and treatment of a patient with diabetic nephropathy accom- panied by spontaneous retroperitoneal hemorrhage after hemodialysis. An elderly female patient with diabetic neph- ropathy presented with severe pain, numbness, and an increasing swelling in the left hip and left thigh after six ses- sions of hemodialysis involving the use of an antiplatelet drug and an anticoagulant agent. Her hemoglobin decreased to 46 g/L. An abdominal ultrasound showed a hematoma in the left retroperitoneal space, and computed tomography (CT) findings revealed a 6 cm×8 cm×10 cm hematoma in the left psoas muscle. After aggressive supportive therapy [the administration of packed red blood cell transfusion, carbazochrome sodium sulfonate injection, and continuous venovenous hemofiltration (CVVH)], the patient's vital signs stabilized and her hemoglobin increased to 86 g/L. Repeat CT showed that the hematoma had been partially absorbed after two weeks. Eventually, the patient was discharged with stable vital signs. Physicians should be aware of the possibility of spontaneous retroperitoneal hemorrhage, particularly in patients with diabetic nephropathy undergoing hemodialysis involving the use of anticoagulant agents.In this paper, we described the symptoms and treatment of a patient with diabetic nephropathy accom- panied by spontaneous retroperitoneal hemorrhage after hemodialysis. An elderly female patient with diabetic neph- ropathy presented with severe pain, numbness, and an increasing swelling in the left hip and left thigh after six ses- sions of hemodialysis involving the use of an antiplatelet drug and an anticoagulant agent. Her hemoglobin decreased to 46 g/L. An abdominal ultrasound showed a hematoma in the left retroperitoneal space, and computed tomography （CT） findings revealed a 6 cm×8 cm×10 cm hematoma in the left psoas muscle. After aggressive supportive therapy [the administration of packed red blood cell transfusion, carbazochrome sodium sulfonate injection, and continuous venovenous hemofiltration （CVVH）], the patient＇s vital signs stabilized and her hemoglobin increased to 86 g/L. Repeat CT showed that the hematoma had been partially absorbed after two weeks. Eventually, the patient was discharged with stable vital signs. Physicians should be aware of the possibility of spontaneous retroperitoneal hemorrhage, particularly in patients with diabetic nephropathy undergoing hemodialysis involving the use of anticoagulant agents.

关 键 词：SPONTANEOUS RETROPERITONEAL hemorrhage Diabetic NEPHROPATHY HEMODIALYSIS NADROPARIN calcium 

分 类 号：R692[医药卫生—泌尿科学]