Spontaneous perirenal hematoma in a lupic patient on haemodialysis treatment and with renal cysts

Loureiro, Juliana Lins; Mendonça, Katienne Goes; Pacheco, Georgia de Araújo; Soutinho, Maria Fernanda Lucena; Presídio, Gustavo Álvares; Ferreira, André Felipe dos Santos; Silva, Agenor Antônio Barros da; Ressurreição, Fernando Melro Silva da; Gouveia, É.; Oliveira, Carlos Alexandre Ferreira de; Medeiros, M.F.C.; Bernardo, Rogério César Correia

doi:10.5935/0101-2800.20130025

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…In the reviewed cases shown in Table 1 , approximately 36% (4/11) patients were on renal replacement therapy, while 55% (6/11) of patients had a normal renal function, and 9% (1/11) patients experienced AKI. Fifteen% (2/13) of reported cases had cystic renal diseases [ 10 , 13 ]. There were neither neoplasms nor infection (abscess or pyelonephritis) induced hemorrhage among the included cases.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous perirenal hemorrhage in systemic lupus erythematosus: a rare case report and literature review

et al. 2021

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Background Spontaneous perirenal hemorrhage is relatively uncommon but may be life-threatening. There are some challenges in early diagnosis due to the lack of specific presentations. Case presentation We report a case of spontaneous perirenal hemorrhage in a newly diagnosed systemic lupus erythematosus patient who initially presented with non-specific flank pain. Weakness and unstable vital signs were noted on admission. Abdominal ultrasonography and computed tomography revealed a sizable perirenal hematoma over the left retroperitoneal cavity. Renal arteriography identified active extravasation of contrast media from a distant branch of the left renal artery, and selective embolization effectively obliterated the bleeding spot. After cessation of bleeding, the patient received intensive immunosuppressive therapy for acute kidney injury and encephalopathy due to lupus. Her mental status recovered successfully, and she was withdrawn from short-term hemodialysis. Conclusions Spontaneous perirenal hemorrhage in the condition of systemic lupus erythematosus was a rare clinical entity with life-threatening potential. Early accurate diagnosis of spontaneous renal hemorrhage requires both detailed clinical examination and radiologic studies. Interventional embolization is essential and effective for both diagnosis and treatment. A high index of suspicion is necessary to avoid missing this potentially fatal syndrome, especially in patients with an increased risk of bleeding.

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Section: Discussionmentioning

confidence: 99%

Spontaneous perirenal hemorrhage in systemic lupus erythematosus: a rare case report and literature review

et al. 2021

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Management of retroperitoneal hemorrhage compressing the inferior vena cava in a patient with a renal transplant: A case report

Fontaine

Garneau

Lemieux

2020

Radiology Case Reports

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Ruptura espontânea da veia renal em gestante: um relato de caso

Rodrigues

Lucas

et al. 2016

Rev. Fac. Ciênc. Méd. Sorocaba

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RESUMOHematomas espontâneos perirrenais são condições graves e que demandam atenção imediata. Embora tenham sido descritos na literatura científica desde o final do século XIX, sua etiologia não é conhecida completamente. O presente artigo relata o caso de uma paciente, 34 anos, gestante de 39 semanas, que foi admitida com queixa de dor abdominal aguda. Não apresentava alterações no exame físico e na ultrassonografia transabdominal. Houve piora posterior, e,por isso, foi encaminhada ao bloco cirúrgico para cesariana de urgência, por suspeita de descolamento prematuro de placenta. Identificou-se, então, hemoperitônio volumoso com hematoma retroperitoneal à direita. Palavras-chave: veias renais; ruptura espontânea; nefrectomia; abdome agudo; gravidez. ABSTRACTSpontaneous perirenalhematoma are serious conditions that demand immediate attention. Although they have been described in the scientific literature since the late nineteenth century, its etiology is not fully understood. The present study reports the case of a 34 year-old patient, 39 weeks pregnant, that had been admitted complaining of acute abdominal pain. Physical examination was unremarkable, as well as the examination of transabdominal ultrasound. Her condition worsened later and she was referred to the operating room for emergency cesarean section for suspected placenta previa. She was identified then hemoperitoneum with bulky retroperitoneal hematoma on the right side. Keywords: renal veins; rupture, spontaneous; nephrectomy; abdomen, acute; pregnancy. INTRODUÇÃOHematomas espontâneos perirrenais foram descritos primeiramente por Wünderlich, em 1856.1 Ocorrem raramente e manifestam-se por dor súbita no flanco ipsilateral, sem histórico de trauma e choque hipovolêmico.1,2 A etiologia dessa condição ainda não é completamente conhecida, mas pode decorrer de: aumento súbito na pressão sanguínea da veia renal; crescimento rápido de tumor -promovendo obstrução das tributárias da veia renal; necrose tumoral que leve à ruptura e hemorragia direta da veia; angiomiolipomas; carcinoma de células renais; distúrbios vasculares -como a poliarterite nodosa e as discrasias sanguíneas; cistos renais; lúpus; entre outros.2,3 É uma condição grave e potencialmente fatal. 4A abordagem de pacientes que apresentam tal quadro é baseada no tratamento do choque, mesmo que não se conheça a causa precisa. Sintomas clínicos da hemorragia perirrenal -entidade grave -são frequentemente não específicos.Métodos de imagem são imperativos, porém, no diagnósticodo hematoma e de sua extensão, e os exames radiológicos têm papel fundamental no processo de localização da hemorragia. 2,5 RELATO DE CASOPaciente do sexo feminino, 34 anos, hígida, gestante de 39 semanas, que já passou por duas gravidezes -uma das quais é a referente a este relato de caso -, deu à luz a um nascido vivo e não teve perdas fetais espontâneas ou abortos induzidos (G2P1A0). A paciente compareceu a todas as consultas de pré-natal agendadas pelo Centro de Saúde, o que indica a adequação desse acompanhamento. Foi admitid...

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Spontaneous perirenal hematoma in a lupic patient on haemodialysis treatment and with renal cysts

Cited by 3 publications

References 16 publications

Spontaneous perirenal hemorrhage in systemic lupus erythematosus: a rare case report and literature review

Spontaneous perirenal hemorrhage in systemic lupus erythematosus: a rare case report and literature review

Management of retroperitoneal hemorrhage compressing the inferior vena cava in a patient with a renal transplant: A case report

Ruptura espontânea da veia renal em gestante: um relato de caso

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