Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure

Greco, Michele; Butticè, Salvatore; Benedetto, Filippo; Spinelli, Francesco; Traxer, Olivier; Tefik, Tzevat; Pappalardo, Rosa; Magno, Carlo

doi:10.1155/2016/2573476

Cited by 11 publications

(16 citation statements)

References 11 publications

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“…The use of anticoagulant therapy is also another cause that has been reported to trigger these bleeds. [3] Interestingly, on review of literature, we found only one case report of a spontaneous perinephric hematoma developing secondary to the use of a NOAC, namely dabigatran. [6] Our case had a similar history of prior use of a NOAC, apixaban for paroxysmal atrial fibrillation.…”

Section: Discussionmentioning

confidence: 91%

“…These bleeds are classically described to present in the form of Lenk's triad with acute flank pain, flank mass and hypovolemic shock. [1] Whilst some of these hematomas are reported to occur spontaneously, [1] secondary causes such as renal tumors, [2] the use of anticoagulant therapy [3] and procedural complications of renal biopsy [4] are also frequently reported. Amongst renal tumors, angiomyolipomas and renal cell carcinomas are known to be most frequently associated with perinephric hematomas.…”

Section: Introductionmentioning

confidence: 99%

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Perinephric hematoma induced by factor Xa inhibitor in a patient with a vascular renal mass

Hussaini

Bakhsh

2020

Journal of Translational Internal Medicine

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Perinephric hematomas are known to present in the form of Lenk’s triad with acute flank pain, flank mass and hypovolemic shock. Here, we describe a case of perinephric hematoma occurring secondary to the use of anticoagulant therapy in the setting of a renal mass. To the best of our knowledge, this is the first reported case of a perinephric hematoma occurring secondary to the use of Apixaban. The patient was an 80 year old male with a history of the presence of a left sided vascular renal mass discovered seven years ago admitted from a peripheral health center with pneumonia and a dropping hemoglobin along with acute kidney injury. Evaluation of his course revealed the use of a Factor Xa inhibitor, namely Apixaban, for new onset atrial fibrillation. The patient was stabilized with multiple units of packed red blood cell transfusions. An abdominal computed tomography abdomen demonstrated a perinephric hematoma contained in the Gerotas fascia. Due to deranged renal function, the patient was managed conservatively and made a full recovery. This case highlights the challenges associated with the diagnosis of perinephric bleeds. The use of anticoagulation therapy in the setting of a pre-existing vascular lesion remains a dilemma.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Perinephric hematoma induced by factor Xa inhibitor in a patient with a vascular renal mass

Hussaini

Bakhsh

2020

Journal of Translational Internal Medicine

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“…5 Other factors include anticoagulation, nonsteroidal anti-inflammatory drugs, cystic diseases, blood dyscrasia, hypertension, hemodialysis, post-lithotripsy, or ureterorenoscopy. 6,7…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Spontaneous Bilateral Subcapsular Renal Hematoma

Bajaj

Trang

Nasrawi

et al. 2020

Journal of Investigative Medicine High Impact Case Reports

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Spontaneous bilateral renal subcapsular hematoma is a rare condition. On literature review, only 2 case reports have elucidated possible etiologies for such a presentation; however, no definite conclusions have been made. We present a rare case of a 52-year-old female with diabetes mellitus type 2, chronic kidney disease stage 4, hypertension, hyperlipidemia, prior traumatic brain injury via motor vehicle accident, who presented to our hospital with diabetic ketoacidosis and clinical signs of pyelonephritis; subsequently, imaging demonstrated spontaneous bilateral renal subcapsular hematoma. Risk factors for the rare presentation in this patient included pyelonephritis, history of bilateral ureteral stent placement, and a remote history of a mild unilateral renal laceration secondary to a motor vehicle accident. Typically, patients with this condition achieve spontaneous resolution with conservative management. Our patient initially presented with diabetic ketoacidosis and pyelonephritis but gradually developed retroperitoneal bleeding and hemorrhagic shock. Our patient’s critical condition required close monitoring in an intensive care unit and a more invasive approach including unilateral left renal artery embolization followed by a unilateral left nephrectomy. The patient ultimately recovered and continued to be followed outpatient without any serious long-term complications.

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“…Renal pelvic haematomas usually present in patients with pre-existing renal pathology such as renal stones, cancer or in the setting of trauma. 4 Having a non-traumatic spontaneous pelvic haematoma in a patient who is otherwise fit and well is very rare with only a few reported cases in the literature. There have been reported cases of large renal pelvis haematomas in uretero-pelvic junction obstruction presenting as an acute abdomen.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous renal pelvis haematoma presenting as renal colic

2019

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Spontaneous renal pelvic haematomas are rare, often mimicking symptoms of other pathologies such as a renal tumour or renal calculi. Spontaneous renal haematoma was first reported by Bonet in 1679 and later described by Wunderlich in 1856. We present the case of a young female patient with no known comorbidities who presented with spontaneous renal pelvis haematoma. Misinterpretation of this finding can lead to erroneous diagnoses.

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Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure

Cited by 11 publications

References 11 publications

Perinephric hematoma induced by factor Xa inhibitor in a patient with a vascular renal mass

Perinephric hematoma induced by factor Xa inhibitor in a patient with a vascular renal mass

A Rare Case of Spontaneous Bilateral Subcapsular Renal Hematoma

Spontaneous renal pelvis haematoma presenting as renal colic

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