Hemorrhagic shock and obstructive uropathy due to a large rectus sheath hematoma in a patient on anticoagulant therapy

Jiro Toyonaga, Kazuhiko Tsuruya, Kohsuke Masutani, Hiroto Maeda, Kuniyuki Nakamura, Masatomo Taniguchi, Hideki Hirakata, Mitsuo Iida

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

A 54-year-old woman was transferred to our hospital with disseminated intravascular coagulation, and was treated with heparin. On hospitalization day 13, she developed lower abdominal pain and mass followed by circulatory shock. She became oliguric and laboratory tests showed serum creatinine of 3.5 mg/dL and hemoglobin of 7.4 g/dL. Computed tomography showed hematoma in the left rectus sheath, compressing the urinary bladder exteriorly, which resulted in worsening of bilateral hydronephrosis. Conservative treatment resulted in resolution of the rectus sheath hematoma and improvement of renal function. Rectus sheath hematoma can be treated conservatively without surgical intervention even in complicated cases.

Original languageEnglish (US)
Pages (from-to)2119-2122
Number of pages4
JournalInternal Medicine
Volume48
Issue number24
DOIs
StatePublished - Dec 1 2009

Keywords

  • Acute renal failure
  • Anticoagulant therapy
  • Obstructive uropathy
  • Rectus sheath hematoma
  • Shock

ASJC Scopus subject areas

  • Internal Medicine

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    Toyonaga, J., Tsuruya, K., Masutani, K., Maeda, H., Nakamura, K., Taniguchi, M., Hirakata, H., & Iida, M. (2009). Hemorrhagic shock and obstructive uropathy due to a large rectus sheath hematoma in a patient on anticoagulant therapy. Internal Medicine, 48(24), 2119-2122. https://doi.org/10.2169/internalmedicine.48.2440