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Pelvic Hematoma

Pelvic Haematoma


Presentation

  • Spontaneous hematomas are rare and can present with acute or chronic symptoms. Our patient presented with deep vein thrombosis of the lower extremity associated with a spontaneous pelvic hematoma.[ncbi.nlm.nih.gov]
  • We present a case of an ulcerated perforation of the bladder caused by a large pelvic hematoma without any direct injury to the bladder in a 71-year-old woman.[ncbi.nlm.nih.gov]
  • Macroscopically, a mass of 6 cm was present impinging on the pelvi-caliceal system. Microscopically, the lesion was composed by hemorragic material with feature of an hematoma.[ncbi.nlm.nih.gov]
  • Mycoplasma hominis was isolated in pure culture from six of seven specimens taken from a retroperitoneal hematoma over a one-week period, and mycoplasmacidal antibodies were present in high titer in the convalescent-phase serum.[ncbi.nlm.nih.gov]
  • We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency.[urologyannals.com]
Perineal Pain
  • Keywords Perineal Pain Rectal Pain Pelvic Brim Iodoform Pelvic Hematoma These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.[link.springer.com]
Abdominal Pain
  • Abstract In a woman patient aged 80 years under anticoagulation with dicumarol (Marcumar), abdominal pain suddenly occurred which was located on the right side as well as signs of acute bleeding.[ncbi.nlm.nih.gov]
  • Conclusion Keeping a high suspicion of abdominal haemorrhage is important if a patient on long term warfarin therapy presented with abdominal pain.[omicsonline.org]
  • Holmes,SJ, Yale SH, Mazz JJ, Rectus sheath hematoma as a cause of acute abdominal pain, Am Fam Physician, 2001;64(10):1681–2.[radcliffecardiology.com]
  • The clinical triad of abdominal pain, abdominal mass (frequently infra-umbilical), and anemic syndrome in a patient on anticoagulation therapy should raise suspicion of this entity.[ispub.com]
  • However, there are cases in which no definite pathology can be identified; and for which the term "abdominal apoplexy" has been given. 2 Patients usually present with abdominal pain, nausea and vomiting.[annsaudimed.net]
Pelvic Mass
  • Two weeks following cardiac catheterization at time of myocardial infarction a patient was noted to have a complex pelvic mass on ultrasound and serum CA-125 of 53 units per milliliter.[ncbi.nlm.nih.gov]
  • While ultrasound (US) might properly demonstrate the presence of an anterior pelvic mass, this modality may not provide a definitive diagnosis.[ispub.com]
Liver Dysfunction
  • Its clinical presentation includes fever, pelvic pain, leukocytosis, thrombocytosis and occasionally liver dysfunction. Surgical outcome is generally unaffected. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.[ncbi.nlm.nih.gov]
Pelvic Pain
  • The emergency physician should consider this rare cause of pelvic pain in selected anticoagulated patients.[ncbi.nlm.nih.gov]
  • Pelvic hematoma should be strongly considered in the patient with lower abdominal, hip, or pelvic pain after blunt injury from parachute landing fall even in the absence of associated fracture.[ncbi.nlm.nih.gov]
  • All cases occurred after transvaginal hysterectomy, 25 (90%) presented with fever, 20 (71%) with pelvic pain and 5 (20%) with urinary retention. All hematomas were diagnosed by ultrasound.[ncbi.nlm.nih.gov]
Renomegaly
  • Pathologic findings include massive subepithelial and peripelvic hemorrhage, hydronephrosis, cortical infarcts, and renomegaly.[ncbi.nlm.nih.gov]
Adnexal Mass
  • Abdominal-pelvic CT-scan showed a small left pleural effusion, minimal ascites, left lower quadrant abdominal wall masses consistent with omental metastases, and a 9.4 x 10.3 x 9.0-cm complex left adnexal mass.[ncbi.nlm.nih.gov]

Workup

  • Earlier in the day, the patient underwent ultrasound evaluation of the abdomen, as part of her workup for elevated liver enzymes found at the time of admission.[ispub.com]
Left Pleural Effusion
  • Abdominal-pelvic CT-scan showed a small left pleural effusion, minimal ascites, left lower quadrant abdominal wall masses consistent with omental metastases, and a 9.4 x 10.3 x 9.0-cm complex left adnexal mass.[ncbi.nlm.nih.gov]
Thrombocytosis
  • Laboratory data included leukocytosis (71%), thrombocytosis (57%) and elevated liver enzymes (18%). Nine patients (33%) required ultrasound-guided drainage of the hematoma, which resulted in marked clinical improvement.[ncbi.nlm.nih.gov]
Mycoplasma Hominis
  • Mycoplasma hominis was isolated in pure culture from six of seven specimens taken from a retroperitoneal hematoma over a one-week period, and mycoplasmacidal antibodies were present in high titer in the convalescent-phase serum.[ncbi.nlm.nih.gov]

Treatment

  • Investigation and treatment of this diagnostic problem are uncertain. METHODS: We add 6 patients with this entity to the 15 previously published cases. All 6 were clinically suspected of having cancer, and 5 underwent nephrectomy.[ncbi.nlm.nih.gov]
  • The transobturator tape (TOS) procedure is rapidly becoming a preferred treatment for female stress urinary incontinence due to excellent outcomes and minimal morbidity. Though rare, significant bleeding complications can occur.[ncbi.nlm.nih.gov]
  • Articles include: Treatment of Aortic Aneurysms; Bariatric Surgical Procedures, Repeat Cesarean Deliveries; Thoracic and Cardiovascular Surgery; Abdominal and Pelvic Viscera; Abdominal, Pelvic Surgical and Post-procedural Foreign Bodies; Thorax; Kidneys[books.google.com]
  • Warfarin treatment was reinitiated as small dose with adjustment of the dose during hospital stay.[omicsonline.org]
  • Emergency treatment is needed with severe injuries and surgery will be necessary to reset the bone and sort out any ruptured blood vessels.[healdove.com]

Prognosis

  • This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional.[healdove.com]
  • A person would have to come in immediately to be treated,” said Samadi, while noting that he has not treated Chavez and, therefore, could not be sure of the leader's prognosis.[foxnews.com]
  • The management is by laparotomy and control of hemorrhage from the bleeding point, and when the origin of the bleeding is not found, the prognosis is poor. 5 Our case was treated conservatively after excluding obvious cause by CT scan and angiography.[annsaudimed.net]
  • The location of a hematoma plays a role in its prognosis . From Reviewed by: Tova Alladice, M.D. American Board of Physical Medicine & Rehabilitation[rxlist.com]

Etiology

  • Pathology Etiology Causes of a pear-shaped bladder include: pelvic fluid pelvic hematoma: the original description of the inverted pear-shaped bladder was in patients with pelvic trauma and hematoma; it can also be seen in patients receiving anticoagulation[radiopaedia.org]
  • Non-operative management is recommended A 67-year-old woman hospitalized for acute pulmonary failure of unknown etiology developed a one-day history of increasing lower abdominal pain and distension associated with new-onset tachycardia and hypotension[ispub.com]

Epidemiology

  • Landefeld CS, Beyth RJ (1993) Anticoagulant-related bleeding: clinical epidemiology, prediction and prevention. Am J Med 95: 315-328. Coon WW, Willis PW 3rd (1974) Hemorrhagic complications of anticoagulant therapy. Arch Intern Med 133: 386-392.[omicsonline.org]
Sex distribution
Age distribution

Prevention

  • Early recognition, prompt diverting colostomy, and aggressive wound management are necessary after open pelvic fracture to prevent local and systemic infectious sequelae of PHN.[ncbi.nlm.nih.gov]
  • The pressure of the hematoma on the iliac vein prevented fluid resuscitation using this route. A pelvic hematoma should be suspected in patients with iliac vein obstruction after blunt pelvic trauma even in the absence of fractures.[ncbi.nlm.nih.gov]
  • Awareness of this rare condition may prevent unnecessary surgical explorations in doubtful situations.[ncbi.nlm.nih.gov]
  • Early recognition, prompt diverting colostomy, and aggressive wound management are necessary after open pelvic fracture to prevent local and systemic infectious sequelae of PHN. Williams & Wilkins 1994. All Rights Reserved.[journals.lww.com]
  • It is indicated for the prevention of systemic embolism in patients with prosthetic heart valves or atrial fibrillation and for the primary and secondary prevention of venous thromboembolism [ 2 , 9 ].[omicsonline.org]

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