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 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]
Entire Body System
- Fever
The fever abated after thorough surgical drainage of the infected hematoma. [ncbi.nlm.nih.gov]
MD; MADOFF, SARABELLE BS Notes: PDF Only Abstract Fever developed in a previously healthy young man who had sustained extensive pelvic trauma. [journals.lww.com]
Post operative pelvic hematoma can cause pain, fever, discharge, diarrhea, and mild abdominal distension, and if large, even paralytic ileus.Since most studies describe fever as a common finding in women with pelvic hematomas [ 4 ], it seems that infection [omicsonline.org]
- Sepsis
While most people recover from mild sepsis, about 15 percent die, according to the Mayo Clinic. In cases of severe sepsis, some studies indicate that the mortality rate is close to 50 percent. [foxnews.com]
MartinezPineiro 552 Intravenous Uroperitoneogram JA MartinezPineiro 554 Coitus Interruptus JA MartinezPineiro 555 Exploding Bladder J Motsch Ch Schramm 556 Education by Humiliation By Far the Best Way of Learning AR Mundy 557 Vena Caval Injury CA Olsson 558 False Sepsis [books.google.com]
However, some authors (3,4) have reported fewer complications, such as fistula, failure to heal, clot retention, and sepsis, with open repair (5% overall) versus conservative management (12% overall). [bjuinternational.com]
- Ascites
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]
He underwent abdomen and pelvis ultrasound for assessment of ascites, which showed localized fluid collections identified at the left and right iliac fossa. [panafrican-med-journal.com]
1743 Postoperative Complications 359 References 361 Acute Postoperative Complications M Seitz B Schlenker Ch Stief 364 1812 Chest Pains and Dyspnea 373 1813 Acute Abdomen 377 1814 Postoperative Fever 378 1815 Abdominal Wound Dehiscence 403 1816 Chylous Ascites [books.google.com]
Serious sequelae could develop and include infection of the lymphocele, obstruction and infection of the urinary tract, intestinal obstruction, venous thrombosis, pulmonary embolism, chylous ascites and lymphatic fistula formation. [1] On clinical examination [en.wikipedia.org]
- Gangrene
Treatment of Urinary Fistulae Through a Sacral Scar in a Paraplegic Patient F TrigoRocha 574 Entrapped Foley Catheter After Radical Prostatectomy NL Türkeri 576 Unexpected Inferior Vena Caval Thrombus ED Vaughan Jr 577 The Lord of the Rings Fourniers Gangrene [books.google.com]
Respiratoric
- Dyspnea
[…] complications During TURB 344 References 347 Complications in Laparoscopic Surgery M Muntener FR Romero LR Kavoussi 349 1743 Postoperative Complications 359 References 361 Acute Postoperative Complications M Seitz B Schlenker Ch Stief 364 1812 Chest Pains and Dyspnea [books.google.com]
Case report A 46-year-old woman with history of obesity, diabetes mellitus and chronic arterial hypertension presented to her local hospital with progressive dyspnea. [bjuinternational.com]
Gastrointestinal
- Abdominal Pain
We report two patients who presented with abdominal pain, later confirmed as abdominal wall and intraabdominal hematoma by computed tomography of abdomen. [omicsonline.org]
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]
The pain is typically sharp and severe with an associated abdominal mass. [radcliffecardiology.com]
A 79-year-old woman who was taking warfarin and enoxaparin because of deep venous thrombosis reported abdominal pain after coughing. On physical examination, a mass was felt in the left side of the abdomen. [nejm.org]
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]
- Pelvic 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]
Discussion In this case, renal pelvic mass associated with recurrent gross haematuria was suspected to be pelvic malignancy leading to radical left nephrectomy, and was pathologically diagnosed as a pelvic haematoma with underlying chronic pyelonephritis [academic.oup.com]
While ultrasound (US) might properly demonstrate the presence of an anterior pelvic mass, this modality may not provide a definitive diagnosis. [ispub.com]
On her admission, the patient had mild fever (38°C), with slight mucocutaneous pallor, and a painless pelvic mass. This mass was reaching halfway to the umbilicus, but its size was not well defined. Her hemoglobin level was 8 g/dl. [omicsonline.org]
- Acute Abdomen
The cause for acute presentation in a case of large pelvis clot is severe stretching of renal pelvis causing nonsuppurative perirenal inflammation. Hence, urological pain might mimic an acute abdomen. [urologyannals.com]
Postoperative Complications M Seitz B Schlenker Ch Stief 364 1812 Chest Pains and Dyspnea 373 1813 Acute Abdomen 377 1814 Postoperative Fever 378 1815 Abdominal Wound Dehiscence 403 1816 Chylous Ascites 410 1817 Deep Venous Thrombosis 414 1818 Lymphoceles [books.google.com]
This condition may, however, present similarly to an acute abdomen or intra-abdominal or pelvic hemorrhage, and may prompt unnecessary laparotomies. (3) Proper evaluation, including CT scan, can assist in making the correct diagnosis and avoidance of [ispub.com]
- Suprapubic Pain
A few hours after the procedure, the patient complained of severe and persistent perianal and suprapubic pain, without relief factors at that time. A physical examination showed no change, and it was found that his vital signs were preserved. [scielo.br]
Cardiovascular
- Thrombosis
Our patient presented with deep vein thrombosis of the lower extremity associated with a spontaneous pelvic hematoma. This lesion was radiologically and clinically indistinguishable from a soft-tissue neoplasm. [ncbi.nlm.nih.gov]
Spontaneous retroperitoneal hematoma with deep venous thrombosis of left lower limb managed conservatively 1 Department of Surgery, J. N. Medical College and KLES Dr. [jscisociety.com]
Post-operatively, he developed deep vein thrombosis (DVT) and pulmonary embolism (PE). He was started on anticoagulant therapy which caused a pelvic hematoma resulting in the urethro-vesical anastomosis (UVA) disruption. [wjnu.org]
A 79-year-old woman who was taking warfarin and enoxaparin because of deep venous thrombosis reported abdominal pain after coughing. On physical examination, a mass was felt in the left side of the abdomen. [nejm.org]
Also, when lower limb edema is present, venous thrombosis needs to be considered. [3] Cause [ edit ] The risk of the development of a lymphocele is positively correlated to the extent of the removal of lymphatic tissue during surgery ( lymphadenectomy [en.wikipedia.org]
- Chest Pain
Pains and Dyspnea 373 1813 Acute Abdomen 377 1814 Postoperative Fever 378 1815 Abdominal Wound Dehiscence 403 1816 Chylous Ascites 410 1817 Deep Venous Thrombosis 414 1818 Lymphoceles 416 References 421 Preventing and Managing Infectious Emergencies [books.google.com]
Musculoskeletal
- Fracture
Pelvic hematoma necessitans (PHN), a complication of massive hemorrhagic pelvic fracture, is reported in a 48-year-old pedestrian hit by an automobile. [ncbi.nlm.nih.gov]
Pelvic Fractures With Bleeding - Everything You Need To Know - Dr. [healdove.com]
Urogenital
- Pelvic Pain
The emergency physician should consider this rare cause of pelvic pain in selected anticoagulated patients. [ncbi.nlm.nih.gov]
The diagnosis of pelvic pain may also be challenging in patients with hemophilia. [spandidos-publications.com]
- Urinary Retention
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]
Retention After Hypospadias Repair F Ikoma 548 Hairs in the Urethra of a Hypospadias Patient F Ikoma 549 A Tale of Two Brothers W Månsson 550 Unfortunate Honeymoon Under the Palm Trees JA MartinezPineiro 552 Intravenous Uroperitoneogram JA MartinezPineiro [books.google.com]
It also allows for effective characterization and follow-up of the hematomas’ size and texture and may show other findings such as air-fluid level, gas bubbles and urinary retention. [omicsonline.org]
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]
Further workup with a pelvic computed tomography scan showed a large gluteal hematoma at the surgical site ( Figure 2 ). [healio.com]
[…] mm Back to top Penetrating Pelvic Trauma Journal of Trauma and Acute Care Surgery:October 2016 – Volume 81 – Issue 4 – p 692–698doi: The diagnostic yield of commonly used investigations in pelvic gunshot wounds Schellenberg, Morgan CONCLUSION: In the workup [crashingpatient.com]
Extraperitoneal rupture can usually be managed with an indwelling bladder catheter. 11 Laboratory Workup Blood analysis should be sent for all patients with a suspected pelvic injury. [ahcmedia.com]
Treatment
The patient was given antibiotic treatment for two weeks with subsequent good clinical improvement. Four months after the treatment, the hematoma size decreased (59.5%) and the patient was set for a continuous follow up (Figures 2 and 3). [omicsonline.org]
The diagnosis and treatment of traumatic retroperitoneal hematoma. [pjms.com.pk]
The clinical findings subsided following initiation of treatment with recombinant activated FVII (rFVIIa). The treatment included 90 mcg kg −1 every 3 h for 3 days. [spandidos-publications.com]
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]
Prognosis
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]
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]
What Is the Prognosis for Hematoma? Blood vessels are routinely injured and may leak blood causing hematomas or blood clots. Depending upon their size and location, hematomas may be insignificant or may cause life-threatening damage. [emedicinehealth.com]
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]
Magnetic resonance imaging and computed tomography myelography showed that the patient had minimal lumbar stenosis ( Figure 1 ), thereby excluding lumbar stenosis as the etiology of her neurologic deficit. [healio.com]
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]
Iliopsoas haematoma leads to compression of the femoral nerve due to the developing lesion in the muscle; there is generally no traumatic etiology and the first occurrence is sudden, with intense lower abdominal or groin pain ( 9 ). [spandidos-publications.com]
Note that it is not possible to specify the exact etiology of the case. We adopted a conservative approach and the patient progressed uneventfully. [scielo.br]
Epidemiology
Bowen v Contents 1 Epidemiology of Hip and Pelvis Injury. .. .. .. .. .. .. . 1 Brandon Larkin 2 Physical Examination of the Hip and Pelvis. .. .. .. .. . 9 devin P. McFadden and Peter H. [books.google.es]
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]
The epidemiology of pelvic ring fractures: a population-based study. J Trauma 2007; 63: 1066–73. doi: 10.1097/TA.0b013e3181589fa4 [PubMed] [CrossRef] [Google Scholar] 17. [ncbi.nlm.nih.gov]
Epidemiology The overall mortality rate for patients with pelvic ring fractures is approximately 6%. 2 This rate increases to 18-40% in patients with uncontrolled pelvic-related hemorrhage. [ahcmedia.com]
Pathophysiology
[…] discharge, diarrhea, and mild abdominal distension, and if large, even paralytic ileus.Since most studies describe fever as a common finding in women with pelvic hematomas [ 4 ], it seems that infection and/or inflammation play an important role in the pathophysiology [omicsonline.org]
Prevention
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]
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]
Preventing Injuries Most injuries can be prevented by following all of the safety components of your normal activities. [healdove.com]