Three cases of spontaneous lumbar artery rupture in hemodialysis patients

Hwang, Na Kyoung; Rhee, Harin; Kim, Il Young; Seong, Eun Young; Lee, Jun Young; Lee, Soo Bong; Kwak, Ihm Soo; Kim, Chang Won; Song, Sang Heon

doi:10.1111/hdi.12491

Cited by 13 publications

(20 citation statements)

References 8 publications

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“…4,8 Its mortality rate is approximately 23%. 5 There are several reports on the relationship between RPHs and cannulation in ECMO. Extracorporeal membrane oxygenation requires a largediameter catheter for sufficient flow and anticoagulants to prevent thrombosis formation in the circuit.…”

Section: T He Present Case Highlights That Delayed Rphmentioning

confidence: 99%

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Delayed retroperitoneal hemorrhage during veno‐venous extracorporeal membrane oxygenation: a case report

Sugiura

Bunya

Yamaoka

et al. 2019

Acute Medicine & Surgery

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Case There are several reports of retroperitoneal hemorrhage induced by percutaneous femoral cannulation for extracorporeal membrane oxygenation (ECMO). However, there are no reports of delayed retroperitoneal hemorrhage, which develops a few days after ECMO initiation and is unrelated to the ECMO cannulation. Herein, we report a rare case of delayed retroperitoneal hemorrhage during veno‐venous extracorporeal membrane oxygenation (VV‐ECMO). Outcome A 54‐year‐old man was referred to our hospital because of severe acute respiratory distress syndrome. We initiated VV‐ECMO. The patient had severe delirium and was confined to a long‐term supine position to maintain circuit safety. On day 13, computed tomography unexpectedly revealed a large retroperitoneal hemorrhage spreading around the psoas muscle. Conclusion Delayed retroperitoneal hemorrhage can develop during VV‐ECMO management a few days after its initiation. Anticoagulant use and forceful muscular strain could be risk factors of delayed retroperitoneal hemorrhage.

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Section: T He Present Case Highlights That Delayed Rphmentioning

confidence: 99%

“…4 The known risk factors for spontaneous RPH are anticoagulation, antiplatelet therapy, and chronic renal failure. 5 Symptoms of RPH are non-specific and atypical. It appears to be difficult to diagnose RPH as, per reports, 10.1% of all RPH (with various origins) are misdiagnosed initially.…”

Section: Introductionmentioning

confidence: 99%

Delayed retroperitoneal hemorrhage during veno‐venous extracorporeal membrane oxygenation: a case report

Sugiura

Bunya

Yamaoka

et al. 2019

Acute Medicine & Surgery

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“…There were no related trauma or iatrogenic procedures. Current risk factors for idiopathic retroperitoneal hemorrhage include anticoagulation, antiplatelet therapy, and chronic renal failure 8 .…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Hemorrhage During Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 Patientss: Clinical Experience and Review of Literature

Zhang¹,

He²,

Hu³

et al. 2020

Preprint

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Background: Retroperitoneal hemorrhage is a rare and severe complication in patients undergoing extracorporeal membrane oxygenation (ECMO). Retroperitoneal hematoma after the operation of multiple ECMO in a single center at the same time is extremely rare. The causes and treatment options can provide clinical experience and bring some inspiration.Case presentation: Three cases of retroperitoneal hemorrhage patients with Corona Virus Disease-19 (COVID-19) are introduced; they had respiratory failure and were treated with veno-venous ECMO or veno-arterial-venous ECMO. Retroperitoneal hemorrhage occurred during ECMO treatment. Among the three cases, 2 cases were found due to abdominal pain, and 1 case was found because of a decrease in ECMO circuit flow rate and hemoglobin level. 2 cases were treated with transcatheter arterial embolization, and 1 case was treated conservatively. The hemorrhage in each of the 3 cases did not deteriorate. Through early diagnosis and treatment, satisfactory treatment results were achieved for these 3 patients.Conclusions: During the period of ECMO treatment, there is a low incidence of retroperitoneal hematoma, yet it comes with a high risk. This is due to anticoagulant use and some local mechanical injuries. If a decline in blood flow velocity and hemoglobin is detected, retroperitoneal hematoma should be taken into consideration, and early aggressive therapy should be started.

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“…It is reported that spontaneous retroperitoneal hemorrhage may result from abdominal vascular rupture, rheumatologic disease, renal tumors, lumbar artery or venous rupture in anticoagulant administered and hemodialysis patients. 5 , 6 , 9 , 10 We must be wary of spontaneous retroperitoneal hemorrhage if these patients present with flank pain, anemia, and hemodynamic instability.…”

Section: Discussionmentioning

confidence: 99%

A rare life-threatening disease: unilateral kidney compressed by huge chronic spontaneous retroperitoneal hemorrhage

Wei

Chen

et al. 2018

TCRM

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ObjectivesTo study an uncommon life-threatening disease, spontaneous retroperitoneal and perirenal hemorrhage.Case descriptionsA 69-year-old male presented with pain in the left waist and back of 1 month duration. The renal abscess was suspected by magnetic resonance imaging before operation. The perirenal hematoma was cleaned by operation. In another case, the patient had a functional solitary left kidney compressed by a huge retroperitoneal mass and uropenia appeared.ResultsThe first patient died of adult respiratory distress syndrome after surgery. The second patient died of cardiac insufficiency and pulmonary embolism on the second day after evacuation of retroperitoneal hematoma.ConclusionConservative surgery, such as selective arterial embolization, is a reasonable approach in patients with chronic spontaneous retroperitoneal and perirenal space hemorrhage and with poor general condition. We strongly recommend drainage or interventional therapy, but not a major surgery, in patients with poor condition.

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Three cases of spontaneous lumbar artery rupture in hemodialysis patients

Cited by 13 publications

References 8 publications

Delayed retroperitoneal hemorrhage during veno‐venous extracorporeal membrane oxygenation: a case report

Delayed retroperitoneal hemorrhage during veno‐venous extracorporeal membrane oxygenation: a case report

Retroperitoneal Hemorrhage During Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 Patientss: Clinical Experience and Review of Literature

A rare life-threatening disease: unilateral kidney compressed by huge chronic spontaneous retroperitoneal hemorrhage

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