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ZJUS-B
Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology)  2012, Vol. 13 Issue (5): 408-412    DOI: 10.1631/jzus.B1100357
Case Reports     
Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents
Wen-xing Fan, Zheng-xu Deng, Fang Liu, Rong-bo Liu, Ling He, Bogati Amrit, Li Zang, Jing-wen Li, Xian-rong Liu, Song-min Huang, Ping Fu
Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
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Abstract  In this paper, we described the symptoms and treatment of a patient with diabetic nephropathy accompanied by spontaneous retroperitoneal hemorrhage after hemodialysis. An elderly female patient with diabetic nephropathy presented with severe pain, numbness, and an increasing swelling in the left hip and left thigh after six sessions of hemodialysis involving the use of an antiplatelet drug and an anticoagulant agent. Her hemoglobin decreased to 46 g/L. An abdominal ultrasound showed a hematoma in the left retroperitoneal space, and computed tomography (CT) findings revealed a 6 cm×8 cm×10 cm hematoma in the left psoas muscle. After aggressive supportive therapy [the administration of packed red blood cell transfusion, carbazochrome sodium sulfonate injection, and continuous venovenous hemofiltration (CVVH)], the patient’s vital signs stabilized and her hemoglobin increased to 86 g/L. Repeat CT showed that the hematoma had been partially absorbed after two weeks. Eventually, the patient was discharged with stable vital signs. Physicians should be aware of the possibility of spontaneous retroperitoneal hemorrhage, particularly in patients with diabetic nephropathy undergoing hemodialysis involving the use of anticoagulant agents.

Key words： Spontaneous retroperitoneal hemorrhage      Diabetic nephropathy      Hemodialysis      Nadroparin calcium     
Received: 01 December 2011      Published: 04 May 2012
CLC:  R692  
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Wen-xing Fan
Xian-rong Liu
Song-min Huang
Ping Fu
Zheng-xu Deng
Fang Liu
Rong-bo Liu
Ling He
Bogati Amrit
Li Zang
Jing-wen Li
Cite this article:

Wen-xing Fan, Zheng-xu Deng, Fang Liu, Rong-bo Liu, Ling He, Bogati Amrit, Li Zang, Jing-wen Li, Xian-rong Liu, Song-min Huang, Ping Fu. Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2012, 13(5): 408-412.

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http://www.zjujournals.com/xueshu/zjus-b/10.1631/jzus.B1100357     OR     http://www.zjujournals.com/xueshu/zjus-b/Y2012/V13/I5/408

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