Spontaneous Retroperitoneal Hematoma: An Uncommon but Occasionally Fatal Vascular Entity-A Case Report

Bing-Zhong Yang ； Hung-Kai Huang

《The Changhua Journal of Medicine》 17卷3期 (2019/09) Pp. 119-123

https://doi.org/10.6501/CJM.201909_17(3).0003

摘要

Spontaneous retroperitoneal hematoma is an infrequent but potentially serious vascular disease that is associated with significant morbidity and mortality. A large volume of blood can accumulate in the retroperitoneum with few external manifestations, which can remain undetected until hypovolemia develops, resulting in delayed diagnosis and increased morbidity. The etiology of retroperitoneal hematoma is varied, and may be due to administration of increased doses of antithrombotic and anticoagulant therapies for acute coronary syndrome (ACS). Herein, we present a case of retroperitoneal hematoma that occurred as a consequence of interventional coronary procedures and antithrombotic therapy. The patient was a 71-year-old female admitted to the hospital emergency department following a cardiac arrest who underwent post-cardiopulmonary resuscitation with return of spontaneous circulation. Percutaneous coronary intervention (PCI) was performed for ACS, and the patient developed spontaneous retroperitoneal hematoma after receiving PCI, dual antiplatelets and anticoagulant therapy. The patient died due to ischemic bowel disease as a consequence of hypovolemic shock. In conclusion, given the importance of anticoagulant and antithrombotic therapy in the treatment strategy for ACS patients, clinicians should be aware of this potentially fatal vascular entity.

關鍵字

acute coronary syndrome ； anticoagulant ； dual antiplatelet ； spontaneous retroperitoneal hematoma