Not All That Bleeds Is Cancer: Spontaneous Perinephric Hematoma

UNSTRUCTURED Introduction: Cardiovascular disease is a major cause of morbidity and is now the leading cause of death in patients with renal transplants. We report a case of acute myocardial infarction three weeks post renal transplant. Case Report: A 45 year old male renal transplant renal transplant recipient presented three weeks post-transplant with acute chest pain, hypotension and atrial fibrillation. He was found to have Infero-posterior wall myocardial infarction. He was thrombolysed with Tenectaplase, and developed a perinephric hematoma six hours later. He underwent transfusions and pigtail drainage of the hematoma. The hematoma resolved, and he was started on dual anti-platelets with stable renal function. Conclusion: Thrombolysis in the early post-transplant period is considered a very high risk procedure. Our case illustrates the use of the thrombolytic therapy in the early post transplant period and successful management of the attendant complications.

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Does Systematic Preliminar Colour Doppler Study Reduce Kidney Biopsy Complication Incidence?

International Journal of Nephrology ◽

10.4061/2011/419093 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5

Author(s):

Antonio Granata ◽

Fulvio Floccari ◽

Angelo Ferrantelli ◽

Ugo Rotolo ◽

Luca Di Lullo ◽

...

Keyword(s):

Kidney Biopsy ◽

Colour Doppler ◽

Doppler Examination ◽

Doppler Study ◽

Group A ◽

Clinically Significant ◽

Perinephric Hematoma ◽

Group B ◽

Biopsy Complications ◽

Optimal Site

While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned.

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Spontaneous perinephric hematoma due to acquired factor X deficiency in AL amyloidosis

Clinical Kidney Journal ◽

10.1093/ndtplus/sfq217 ◽

2011 ◽

Vol 4 (2) ◽

pp. 101-103

Author(s):

R. Raina ◽

V. Nadig ◽

D. Patel ◽

A. Jegalian ◽

B. Silver ◽

...

Keyword(s):

Al Amyloidosis ◽

Factor X ◽

Factor X Deficiency ◽

Perinephric Hematoma

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PD63-07 PERINEPHRIC HEMATOMA SIZE IS INDEPENDENTLY ASSOCIATED WITH THE NEED FOR UROLOGIC INTERVENTION IN BLUNT RENAL TRAUMA

The Journal of Urology ◽

10.1016/j.juro.2017.02.2931 ◽

2017 ◽

Vol 197 (4S) ◽

Author(s):

Logan Zemp ◽

Uday Mann ◽

Keith Rourke

Keyword(s):

Renal Trauma ◽

Perinephric Hematoma

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Perinephric hematoma induced by factor Xa inhibitor in a patient with a vascular renal mass

Journal of Translational Internal Medicine ◽

10.2478/jtim-2020-0029 ◽

2020 ◽

Vol 8 (3) ◽

pp. 195-198 ◽

Cited By ~ 1

Author(s):

Syed A. Hussaini ◽

Abdul Rahim Ali Bakhsh

Keyword(s):

Renal Mass ◽

Anticoagulation Therapy ◽

Hypovolemic Shock ◽

Factor Xa ◽

Kidney Injury ◽

Vascular Lesion ◽

Factor Xa Inhibitor ◽

History Of ◽

Red Blood Cell Transfusions ◽

Perinephric Hematoma

AbstractPerinephric hematomas are known to present in the form of Lenk’s triad with acute flank pain, flank mass and hypovolemic shock. Here, we describe a case of perinephric hematoma occurring secondary to the use of anticoagulant therapy in the setting of a renal mass. To the best of our knowledge, this is the first reported case of a perinephric hematoma occurring secondary to the use of Apixaban. The patient was an 80 year old male with a history of the presence of a left sided vascular renal mass discovered seven years ago admitted from a peripheral health center with pneumonia and a dropping hemoglobin along with acute kidney injury. Evaluation of his course revealed the use of a Factor Xa inhibitor, namely Apixaban, for new onset atrial fibrillation. The patient was stabilized with multiple units of packed red blood cell transfusions. An abdominal computed tomography abdomen demonstrated a perinephric hematoma contained in the Gerotas fascia. Due to deranged renal function, the patient was managed conservatively and made a full recovery. This case highlights the challenges associated with the diagnosis of perinephric bleeds. The use of anticoagulation therapy in the setting of a pre-existing vascular lesion remains a dilemma.

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Perinephric Hematoma

10.32388/ocufsl ◽

2020 ◽

Author(s):

Keyword(s):

Perinephric Hematoma

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Kidney Biopsy: An Experience from Tertiary Hospital

Journal of Nepal Medical Association ◽

10.31729/jnma.2192 ◽

2014 ◽

Vol 52 (193) ◽

pp. 707-712 ◽

Cited By ~ 1

Author(s):

Madhav Ghimire ◽

Bishnu Pahari ◽

Navaraj Paudel ◽

Gayatri Das ◽

Gopal Chandra Das ◽

...

Keyword(s):

Kidney Biopsy ◽

Tertiary Hospital ◽

Proliferative Glomerulonephritis ◽

Safe Procedure ◽

Mesangial Proliferative Glomerulonephritis ◽

Macroscopic Hematuria ◽

Histological Pattern ◽

Renal Histology ◽

Perinephric Hematoma ◽

Nephrotic Range Proteinuria

Introduction: Kidney Biopsy is an important diagnostic tool in Nephrology. It is useful in Nephrology in terms of diagnosis, prognosis and management. There is little information on renal biopsy data from central Nepal. We describe our center`s experience in kidney biopsy in term of histological patterns, complications and outcomes.Methods: We prospectively analyzed the biopsies data of patients over a period of one and half year. All kinds of kidney disease patients were included for kidney biopsy, irrespective of their clinical syndromes and underlying diagnosis.Results: A total of 75 biopsies were analyzed. Majority of them were females; 56% (n=42). Most of the biopsies; 84% (n=63) were from younger subjects ≤ 45 years and majority of them fell in the age group 11-20 years. Most common clinical renal syndrome to undergo biopsy was Sub Nephrotic range Proteinuria in 53.3% (n=40). Among comorbid conditions, 53.3% (n=40) had Hypertension. The most common histological pattern seen was Mesangial proliferative Glomerulonephritis (MesPGN) seen in 24% (n=18). Among complications associated with the procedure, macroscopic hematuria was seen in 6.7% (n=5) cases and clinically significant perinephric hematoma causing pain was seen in 5.3% (n=4). There was no mortality associated with biopsy procedure.Conclusions: Sub Nephrotic range Proteinuria was the commonest clinical renal Syndrome observed. In terms of renal histology, Mesangial Proliferative Glomerulonephritis (MesPGN) was the commonest histological pattern observed. Kidney biopsy is a safe procedure without any significant adverse events.Keywords: Kidney biopsy, sub nephrotic range proteinuria, mesangial proliferative glomerulonephritis

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