Korean J Crit Care Med.  2015 Nov;30(4):318-322. 10.4266/kjccm.2015.30.4.318.

Spontaneous Lumbar Artery Bleeding and Retroperitoneal Hematoma in a Patient Treated with Continuous Renal Replacement Therapy

Affiliations
  • 1Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea. dhlee@fatima.or.kr
  • 2Department of Radiology, Daegu Fatima Hospital, Daegu, Korea.

Abstract

Rupture of the lumbar artery is usually associated with trauma but rarely has been reported in association with anticoagulation. We present a 71-year-old man who developed spontaneous rupture of the lumbar artery leading to a retroperitoneal hematoma while receiving continuous renal replacement therapy (CRRT). The bleeding was confirmed by computed tomography and angiography and was controlled successfully using selective angiographic embolization. We suggest that spontaneous retroperitoneal bleeding should be considered in a case of sudden decrease in hemoglobin in a CRRT patient.

Keyword

anticoagulation; chronic kidney disease; continuous renal replacement therapy; spontaneous bleeding

MeSH Terms

Aged
Angiography
Arteries*
Hematoma*
Hemorrhage*
Humans
Renal Insufficiency, Chronic
Renal Replacement Therapy*
Rupture
Rupture, Spontaneous

Figure

  • Fig. 1. Chest radiograph showing bilateral pleural effusion.

  • Fig. 2. Computed tomography scans of the abdomen. Large (15 x 20 cm) right retroperitoneal hematoma (arrow) was seen (A). Right iliacus muscle hematoma (arrow) was also detected with retroperitoneal hematoma (B).

  • Fig. 3. Angiography. Contrast leakage was noted in the right lower lumbar artery (arrow) (A). Embolization with gelfoam and microcoils was successful (B).


Reference

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