A 55-year-old man developed deep venous thrombosis and inferior vena cava(IVC) thrombosis 7 years earlier and was treated by placement of a permanent IVC filter. One week ago, he was admitted with bilateral lower limb...A 55-year-old man developed deep venous thrombosis and inferior vena cava(IVC) thrombosis 7 years earlier and was treated by placement of a permanent IVC filter. One week ago, he was admitted with bilateral lower limb swelling and pain. Digital subtraction angiography showed a filling defect above the original filter. A retrievable Tulip filter was placed and catheter-directed thrombolysis was performed. Six days later, the patient experienced sudden, persistent upper right abdominal pain, and a computed tomography scan revealed the formation of retroperitoneal hematoma. Symptomatic treatments were administered, and the hematoma gradually resolved during follow-up.展开更多
Background: Retroperitoneal heamorrahge is an acute surgical condition that is associated with difficulty of diagnosis, organ injuries and mortality. Materials and Methods: One hundred and two patients with traumatic ...Background: Retroperitoneal heamorrahge is an acute surgical condition that is associated with difficulty of diagnosis, organ injuries and mortality. Materials and Methods: One hundred and two patients with traumatic retroperitoneal hematoma treated in Al Yarmuk teaching hospital from May 2012 to January 2013 were reviewed retrospectively. The data include patient’s age, type of injury, presenting symptoms, associated injuries and common site of hematoma. Results: In 102 patients, 69 were males (67.6%) and 33 were females (32.3%), mean age of 22 years. The comments presenting symptoms was pain (85.2%), followed by tenderness (73.5%) and shock (58.8%). Around 38.2% were injured by blunt trauma and 61.8% by penetrating trauma. The large bowel was the most common affected organ 26.4%, spleen and kidneys were the second affected organ (23.5%) while the jejunum and ileum were the third associated organs to be affected (14.7%). The commonest complication was septicemia, followed by wound infection. The least reported complications were Pulmonary embolism, Fistula, and Intestinal Obstruction. Conclusion: Traumatic retroperitoneal hematoma is life-threatening condition, early diagnosis and correct treatment is of upmost importance.展开更多
Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpa...Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.展开更多
BACKGROUND Retrograde intrarenal surgery(RIRS)has been proven to be a safe and effective treatment modality in large-scale quantitative studies.However,although its safety profile has been established,it also has a po...BACKGROUND Retrograde intrarenal surgery(RIRS)has been proven to be a safe and effective treatment modality in large-scale quantitative studies.However,although its safety profile has been established,it also has a potential risk of life-threatening complications.We here describe our experience with a patient who developed a huge periureteral hematoma after RIRS with holmium laser lithotripsy.CASE SUMMARY A 73-year-old woman visited our center with a complaint of gross hematuria.An enhanced computed tomography(CT)scan revealed a 1.5-cm left renal pelvis stone with hydronephrosis.The patient underwent RIRS.During the surgery,a 12/14-Fr ureteral access sheath was applied and a 6-Fr ureteral catheter was indwelled thereafter.On postoperative day 1,she experienced aggravated left flank pain and left lower-quadrant tenderness without rebound tenderness.A follow-up CT scan was taken,which revealed a huge hematoma in the periureteral space,not in the perirenal space,with suspicious contrast medium extravasation.Immediate angiography was performed;however,it showed no evidence of active bleeding.She was conservatively managed with hydration and antibiotic and nonsteroidal anti-inflammatory drug therapy,and was discharged on postoperative day 7.However,she visited our outpatient department with recurrent left flank pain at 5 d from discharge.Ultrasonography confirmed that the double J-stent was intact.To rule out stent malfunction,the stent was changed.Decreased size of the hematoma was observed in the imaging studies,and conservative management for candiduria was performed for 1 wk.CONCLUSION Although RIRS is an effective and safe procedure for the management of renal stones,clinicians should be aware of its potential complications.展开更多
Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.~1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. E...Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.~1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.展开更多
文摘A 55-year-old man developed deep venous thrombosis and inferior vena cava(IVC) thrombosis 7 years earlier and was treated by placement of a permanent IVC filter. One week ago, he was admitted with bilateral lower limb swelling and pain. Digital subtraction angiography showed a filling defect above the original filter. A retrievable Tulip filter was placed and catheter-directed thrombolysis was performed. Six days later, the patient experienced sudden, persistent upper right abdominal pain, and a computed tomography scan revealed the formation of retroperitoneal hematoma. Symptomatic treatments were administered, and the hematoma gradually resolved during follow-up.
文摘Background: Retroperitoneal heamorrahge is an acute surgical condition that is associated with difficulty of diagnosis, organ injuries and mortality. Materials and Methods: One hundred and two patients with traumatic retroperitoneal hematoma treated in Al Yarmuk teaching hospital from May 2012 to January 2013 were reviewed retrospectively. The data include patient’s age, type of injury, presenting symptoms, associated injuries and common site of hematoma. Results: In 102 patients, 69 were males (67.6%) and 33 were females (32.3%), mean age of 22 years. The comments presenting symptoms was pain (85.2%), followed by tenderness (73.5%) and shock (58.8%). Around 38.2% were injured by blunt trauma and 61.8% by penetrating trauma. The large bowel was the most common affected organ 26.4%, spleen and kidneys were the second affected organ (23.5%) while the jejunum and ileum were the third associated organs to be affected (14.7%). The commonest complication was septicemia, followed by wound infection. The least reported complications were Pulmonary embolism, Fistula, and Intestinal Obstruction. Conclusion: Traumatic retroperitoneal hematoma is life-threatening condition, early diagnosis and correct treatment is of upmost importance.
文摘Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.
文摘BACKGROUND Retrograde intrarenal surgery(RIRS)has been proven to be a safe and effective treatment modality in large-scale quantitative studies.However,although its safety profile has been established,it also has a potential risk of life-threatening complications.We here describe our experience with a patient who developed a huge periureteral hematoma after RIRS with holmium laser lithotripsy.CASE SUMMARY A 73-year-old woman visited our center with a complaint of gross hematuria.An enhanced computed tomography(CT)scan revealed a 1.5-cm left renal pelvis stone with hydronephrosis.The patient underwent RIRS.During the surgery,a 12/14-Fr ureteral access sheath was applied and a 6-Fr ureteral catheter was indwelled thereafter.On postoperative day 1,she experienced aggravated left flank pain and left lower-quadrant tenderness without rebound tenderness.A follow-up CT scan was taken,which revealed a huge hematoma in the periureteral space,not in the perirenal space,with suspicious contrast medium extravasation.Immediate angiography was performed;however,it showed no evidence of active bleeding.She was conservatively managed with hydration and antibiotic and nonsteroidal anti-inflammatory drug therapy,and was discharged on postoperative day 7.However,she visited our outpatient department with recurrent left flank pain at 5 d from discharge.Ultrasonography confirmed that the double J-stent was intact.To rule out stent malfunction,the stent was changed.Decreased size of the hematoma was observed in the imaging studies,and conservative management for candiduria was performed for 1 wk.CONCLUSION Although RIRS is an effective and safe procedure for the management of renal stones,clinicians should be aware of its potential complications.
文摘Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.~1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.
