Presentation
Renal hematoma may present with signs and symptoms, which may mimic the clinical presentation of abruptio placentae or rupture uterus. [ncbi.nlm.nih.gov]
In the present study, the clinical presentations and conservative treatment of a SRH following a failed UHL procedure in a young male patient were discussed. [spandidos-publications.com]
BACK TO TOP OF PAGE Case report A 54-year-old female presented with a long history of intermittent micturition and dysuria. She started having high grade fever 5 days ago. On the day of presentation, she had acute onset of left flank pain. [theisn.org]
Entire Body System
- Intravenous Administration
Following the administration of intravenous anesthesia (remifentanil, 2 µg/kg; Rui Jie Ren Fu Inc., Yi Chang, China and propofol, 1.0 mg/kg; De Pu Li Ma; AstraZeneca, Shanghai, China), the patient was placed in the lithotomy position. [spandidos-publications.com]
- Difficulty Walking
However, the low back pain became more intense 1 day after the last LPB, and she had difficulty walking for several days. Pain was localized to the right low back, but sciatica did not increase. The pain was treated with 750 mg oral mephenamic acid. [anesthesiology.pubs.asahq.org]
- Lower Extremity Pain
Lumbar plexus block (LPB) has been described for use in patients with lumbosacral and lower extremity pain. [1-4] Psoas compartment block is one form of LPB. [1]. [anesthesiology.pubs.asahq.org]
- Intermittent Fever
Since the last 3 months, he complained of mild to moderate intermittent fever along with generalized myalgia and arthralgia of small joints. [indianjnephrol.org]
Gastrointestinal
- Abdominal Pain
A 43-year-old man presented with complaints of hematuria and abdominal pain. He had been receiving warfarin for six years, after placement of an aortic valve prosthesis. [ncbi.nlm.nih.gov]
We decided to perform an abdominal computerized tomography (CT) to evaluate the cause of the abdominal pain. [heartviews.org]
Livedo reticularis, nodules, mononeuritis multiplex, abdominal pain, and testicular involvement are well-described features. [indianjnephrol.org]
The characteristic clinical features are abdominal pain, a mass in the flank and signs of internal bleeding. [academic.oup.com]
- Right Flank Pain
She complained of right flank pain and fever and the findings following abdominal echography, computerized tomography (CT) scan and renal angiography agreed with a diagnosis of subcapsular renal hematoma without renal tumor. [ncbi.nlm.nih.gov]
She complained of right flank pain… (More) [semanticscholar.org]
Over the last 1 month, he developed right flank pain that was dull, persistent, without any aggravating or relieving factor. [indianjnephrol.org]
We report a 38-year-old lady presenting with sudden onset right flank pain with uncontrolled hypertension and she was found to have subcapsular collection in the right kidney on ultrasonography. Finding was confirmed on computed tomography. [urologyannals.com]
Case Report A 33-year-old man was referred with right flank pain after ureterorenoscopy procedure. The ureterorenoscopy was performed for 1 cm right distal ureteral stone with pneumatic lithotripsy in an another hospital. [mjdrdypu.org]
Cardiovascular
- Hypertension
A history of hypertension and higher BMI are important predisposing factors to perirenal hematoma. [ncbi.nlm.nih.gov]
If hypertension persists, the renal function deteriorates PAGE KIDNEY: SUBCAPSULAR HAEMATOMA AND ARTERIAL HYPERTENSION. .. Figura 2. [redalyc.org]
His hypertension was induced by renal parenchymal compression (Page kidney), a rare cause of secondary hypertension. Page's experimental model of hypertension, created by wrapping cellophane around animal kidneys, was first described in 1939. [nejm.org]
ABSTRACT A case of Page kidney as a result of injury followed by hypertension is presented. [urotoday.com]
- Cardiomegaly
[…] hepatitis C virus and hepatitis B surface antigen) were negative (serum Ferritin was 171 ng/ml, transferrin saturation was 21%), ultrasound of the abdomen showed grade 1 nephropathy (right kidney 89 mm, left kidney 89 mm length), chest radiograph showed cardiomegaly [sjmms.net]
Musculoskeletal
- Back Pain
Low back pain became more intense 1 day after LPB. The pain was localized in the left low back, and no root signs were noted. The pain was treated with 200 mg intravenous diclofenac. [anesthesiology.pubs.asahq.org]
Abstract An 80-year-old woman was admitted to the hospital complaining of loss of appetite. 10 days earlier, her oral intake gradually decreased with no other specific symptoms, such as abdominal pain, nausea, vomiting, headache, or low back pain. [ncbi.nlm.nih.gov]
She developed a spontaneous right-sided perirenal hematoma, along with back pain, on the day of referral to the nephrology unit and a spontaneous left-sided perirenal hematoma ten days later. [rrtjournal.biomedcentral.com]
[…] and swelling Severe flank pain and back pain Blood in the urine Drowsiness, decreased alertness, including coma Decreased urine output or inability to urinate Fever Increased heart rate Nausea, vomiting Skin that is pale or cool to touch Sweating Long-term [medlineplus.gov]
Urogenital
- Flank Pain
The most common symptoms of renal hematoma are severe flank pain and hematuria. A history of hypertension and higher BMI are important predisposing factors to perirenal hematoma. [ncbi.nlm.nih.gov]
The affected patients present to emergency departments with the symptoms and sings comprising sudden onset flank pain, abdominal tenderness and hematuria. [omicsonline.org]
I also have an ovarian cyst which they are removing this week to see if my flank pain could be referred pain from that. [csn.cancer.org]
She complained of right flank pain… (More) [semanticscholar.org]
Workup
Workup disclosed a large perirenal and retroperitoneal hematoma, this patient was treated with antibiotics, fever eventually resolved spontaneously. [bioaccent.org]
The final genetic workup was available only after discharge and detected a complement factor H haplotype H3 (−332T, c.184G, c.1204T, c.2016G, and c.2808T). [revistanefrologia.com]
Microbiology
- Pseudomonas
Ten days later, this patient developed temperature, the urine culture grew Pseudomonas aeruginosa, and ciprofloxacin was given orally. [dovepress.com]
Other Pathologies
- Fibrinoid Necrosis
No crescents, fibrinoid necrosis nor mesangial proliferation were noted. There was marked tubule-interstitial chronicity (approximately >50% of cortical surface area) including thyroidization of tubules. [sjmms.net]
Hypertrophy
- Ventricular Hypertrophy
European Geriatric Medicine. 2012; 3(2): 121-122 [Pubmed] 4 Spontaneous Renal Hematoma Caused by Hypertension with Left Ventricular Hypertrophy Byoung-Won Park,Min-Gyu Kong,Hye-Young Ju,Jin-Wook Chung,Duk-Won Bang,Min-Su Hyon,Soon-Hyo Kwon,Seong-Sook [urologyannals.com]
hypertrophy, grade 2 left ventricular diastolic dysfunction, ejection fraction was 60%. [sjmms.net]
Other ECG Findings
- Ischemic Changes
Perforation of the sigmoid colon with ischemic change due to polyarteritis nodosa. J Gastroenterol 1999;34:400-4. [ PUBMED ] 19. Chandrakantan A, Kaufman J. Renal hemorrhage in polyarteritis nodosa: diagnosis and management. [indianjnephrol.org]
Treatment
All of them received conservative and supportive treatment without surgical exploration. Ten (50%) patients had a history of hypertension. Renal hematoma developed in 11 patients at the second or third SWL treatment. [ncbi.nlm.nih.gov]
Holmium laser lithotripsy (PowerSuite 60 W; Lumenis, Inc., San Jose, CA, USA) under a rigid ureteroscope was recommended for treatment. [spandidos-publications.com]
Prognosis
Men and patients with a younger age of onset present with a more severe prognosis. [panafrican-med-journal.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]
Corticosteroids plus pulse cyclophosphamide and plasma exchanges versus corticosteroids plus pulse cyclophosphamide alone in the treatment of polyarteritis nodosa and Churg–Strauss syndrome patients with factors predicting poor prognosis. [nature.com]
The clinical, radiological findings, prognosis of a massive perinephric hematoma following a renal biopsy in a high risk patient with severe renal failure are discussed. [sjmms.net]
The prognosis of absorption fever, which can be alleviated with antipyretics or other symptomatic relief and supportive treatment, is good. [journals.lww.com]
Etiology
The main determinants in the treatment are patient’s hemodynamic status and the etiology. [omicsonline.org]
We conclude that conservative management is the first choice for subcapsular renal hematoma without a definite etiology, especially in an elderly patient. [ncbi.nlm.nih.gov]
Zhang JQ, Fielding JR, Zou KH. 2002 Etiology of spontaneous perirenal hemorrhage: A meta-analysis. J Urol.167:1593-1596. [theisn.org]
Etiology of spontaneous perirenal hemorrhage: A meta-analysis. J Urol 2002;167:1593-6. [ PUBMED ] 8. Belville JS, Morgentaler A, Loughlin KR, Tumeh SS. [urologyannals.com]
Epidemiology
Epidemiology of renal trauma: In blunt abdominal trauma, up to 40% present with renal injury. In urban areas, 80% of renal injuries occur in the context of polytrauma. In ski resorts, 2/3 of renal injuries are due to skiing accidents. [urology-textbook.com]
Anticoagulant-related bleeding: clinical epidemiology, prediction, and prevention. Am J Med, 95 (1993), pp. 315-328 [2] A.K. Chakraborty, R.B. Dreisin. Pulmonary hematoma secondary to anticoagulant therapy. [archbronconeumol.org]
Giant cell arteritis is more prevalent in urban than in rural populations: results of an epidemiological study of primary systemic vasculitides in Germany. Rheumatology (Oxford) 39, 1396–1402 (2000). 4. [nature.com]
Pathophysiology
The pathophysiology of hypertension associated with renal compression from perinephric hematoma or chronic perirenal scarring results from an intrarenal artery or segmental branch stenosis [3]. [urotoday.com]
Unlike true capillary hemangiomas that regress in childhood and are a cosmetic nuisance, the lesions in KMS are distinctive vascular tumors, that include tufted angiomas and kaposiform hemangioendotheliomas. 2 The pathophysiology is believed to be consumption [nature.com]
Uremic Bleeding: Pathophysiology, Diagnosis, and Management. Hospital Physician 2001 May; 76 45-50. Mannucci, M. Desmopressin (DDAVP) in the Treatment of Bleeding Disorders: The First 20 Years. Blood 1997 October 90(7): 2515-2521. [emdocs.net]
Prevention
Prevention of this complication is associated with the surgeon's awareness. When the patients have risk factors, this complication must be taken into consideration by urologists. [mjdrdypu.org]
Keywords: spina bifida, paraplegia, ureteroscopy, lithotripsy, subcapsular hematoma, prevention This work is published and licensed by Dove Medical Press Limited. [dovepress.com]
Use of dedicated catheters, stents, wires, and adjunctive medical therapy can prevent complications. [evtoday.com]