Bilateral spontaneous retroperitoneal bleeding in a patient on nimesulide: a case report

Abstract

IntroductionSpontaneous retroperitoneal bleeding is a rare but potentially life-threatening event of varied etiology. Herein we report a case of bilateral non-traumatic retroperitoneal hemorrhage.Case presentationA 50-year-old Greek man, who was on a non-steroidal anti-inflammatory agent (nimesulide) for ankylosing spondylitis, presented with a right retroperitoneal hematoma combined with contralateral subcapsular renal hematoma. Bleeding on his right side was successfully controlled by arterial embolization with coils, whereas the left renal hematoma was treated conservatively. His recovery period was uneventful.ConclusionThis is the first reported case of bilateral retroperitoneal bleeding in a patient receiving nimesulide for ankylosing spondylitis. The application of minimally invasive techniques resulted in the desired positive outcome with preservation of both renal units.

Renal arterial embolization: Indications, angiographic findings, and outcomes in a series of 170 patients

“…Our data are limited for this subgroup of patients, and a paucity of literature is available, including a small case series with a lower success rate [13] and case reports. [15] Ultrasonography and Doppler can be used as initial imaging studies in the evaluation of cases scheduled for RAE. They can detect renal masses, hematomas, and perinephric hematoma well but have low sensitivity for detecting vascular lesions.…”

“…Our data are limited for this subgroup of patients, and a paucity of literature is available, including a small case series with a lower success rate [ 13 ] and case reports. [ 15 ]…”

Spontaneous Subcapsular Renal Hematoma as a Complication of Acute Pyelonephritis: A Case Report

“…Vascular disease causes SSRH to 17%, infection in 2.4% and 6.7% of cases of idiopathic etiology (1). In the literature as a rare cause of SSRH are mentioned hypertension, anticoagulation, nimesulide, percutaneous angiography (6)(7)(8)(9). US is useful for rapid identification of findings, but the diagnosis must be confirmed by MDCT examination, which is the method of choice.…”

“…MDCT has a high sensitivity and specificity to confirm the existence of hematoma, as well as the cause of its occurrence (1,9). Regarding the therapeutic approach, a number of authors in their work suggest that the best solution is non-surgical treatment, which involves percutaneous drainage of the hematoma (as a intervention radiological procedure), with the elimination of the basic causes of this disease (6)(7)(8).…”