Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery?

Chan, Yiu Che; Morales, Jose P.; Reidy, John F.; Taylor, Peter R.

doi:10.1111/j.1742-1241.2007.01494.x

Cited by 204 publications

(247 citation statements)

References 81 publications

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“…It is recommended that all retroperitoneal hemorrhage be treated conservatively, as it is believed that open surgery may disturb the tamponade effect of the retroperitoneum (22). However, there are no specific guidelines to indicate the optimal time to intervene with endovascular or open surgery to stop the bleeding.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Hematoma in a Patient with Advanced Chronic Kidney Disease Receiving Warfarin Therapy

et al. 2016

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A 73-year-old man with chronic kidney disease stage G5 was admitted to our hospital because of a worsening kidney dysfunction. He had undergone prosthetic valve replacement of the mitral valve 5 years previously and was currently taking warfarin. He showed excessive anticoagulation on admission, with a prothrombin time-international normalized ratio (PT-INR) of 3.91. The use of warfarin was ceased and PT-INR decreased to 2.1. Since the patient would need renal replacement therapy, he underwent arteriovenous fistula surgery for hemodialysis access on day 16. However, on day 18, he suddenly complained of lumbago and went into shock. His blood pressure dropped to 73/49 mmHg, and the hemoglobin level fell to 4.9 g/dL.Computed tomography revealed a huge retroperitoneal hematoma. Emergent lumbar artery embolization was performed on two consecutive days; however, the bleeding persisted, with subsequent development of abdominal compartment syndrome with impaired respiratory and cardiovascular function, and the patient died. Autopsy revealed a hematoma measuring 30×20×20 cm involving the psoas muscle and external iliac artery; the hematoma was covered with fibrous tissue instead of muscle. The psoas muscle is supplied by the internal iliac artery; however, a collapsed artery could not be confirmed in our patient. The closest major artery to the hematoma was located at the intersection of the psoas muscle and the external iliac artery. All arteries showed severe atherosclerosis. In patients with advanced chronic kidney disease, anticoagulant therapy should be administered carefully, and the etiology of retroperitoneal hematoma should be further investigated.

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Section: Discussionmentioning

confidence: 99%

Retroperitoneal Hematoma in a Patient with Advanced Chronic Kidney Disease Receiving Warfarin Therapy

et al. 2016

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“…Ultrasound and CT imaging are the most effective ways to make this diagnosis. Patients can be managed either conservatively with close monitoring, fluid resuscitation, cessation/reversal of anticoagulation, and blood transfusions as needed, or more aggressively with endovascular embolization or open repair (9). Open repair is generally reserved for patients who have failed more conservative treatment measures.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Hematoma After Femoral Arterial Catheterization

Vilke

Kass

2015

The Journal of Emergency Medicine

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“…5,6 The risk is higher in those with arterial punctures above the inguinal ligament. 7 We presume that supra-inguinal venous access also increases this risk.…”

Section: Discussionmentioning

confidence: 99%

“…Skin erosion has been described to occur in cases with devices placed in the lower abdominal wall near the inguinal crease. 7 However, historical experience with tunneled leads directed to an anterior abdominal wall location have shown this to be safe and efficacious. 10 Similar to pectoral placement, options exist for subcutaneous and submuscular approaches in the abdominal wall.…”

Section: Discussionmentioning

confidence: 99%

Biventricular ICD Placement Percutaneously Via the Iliac Vein: Case Reports and a Review

Higgins

2017

JICRM

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ABSTRACT. Cardiac resynchronization therapy (CRT) has been demonstrated to improve symptoms of heart failure. As a result, it has become the standard of care in selected patients, and is commonly completed with three leads placed via an upper-extremity vein. However, in rare situations, such as in the case of superior vena cava occlusion, venous access is not possible via the upper extremity. It is in such instances that alternative means must be sought. Here, two patients who received a CRT defibrillator via an iliac vein approach with a mid-abdominal generator are introduced, and a review of the techniques used is presented. Technical aspects to this approach are discussed, including iliac venous access, defibrillation electrode positioning, coronary sinus access, and lead tunneling to an abdominal generator for patient comfort. This approach should be considered when vascular access is compromised, at least until combined leadless CRT pacing and subcutaneous implantable cardioverter-defibrillator devices become available and feasible for use.

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Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery?

Cited by 204 publications

References 81 publications

Retroperitoneal Hematoma in a Patient with Advanced Chronic Kidney Disease Receiving Warfarin Therapy

Retroperitoneal Hematoma in a Patient with Advanced Chronic Kidney Disease Receiving Warfarin Therapy

Retroperitoneal Hematoma After Femoral Arterial Catheterization

Biventricular ICD Placement Percutaneously Via the Iliac Vein: Case Reports and a Review

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