Abstract

BackgroundThe authors herein report a case of pain, femoral vein thrombosis, and inguinal subcutaneous hematoma caused by percutaneous femoral vascular catheterization in a hemodialysis (HD) patient complicated with vascular access occlusion. The pain was well-controlled without using analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs). The thrombosis and hematoma increased in size and was also treated by conservative treatment using traditional Japanese Kampo medicine (jidabokuippo: JDI) to resolve oketsu: a sign of microcirculating disorder. JDI improves the blood circulation in the affected lesion and alleviates contusion-induced blood flow and repairs blood flow without forming thrombosis. These catheter-related complications were successfully treated by JDI.Case presentationA 41-year-old man under HD was admitted because of permanent vascular access failure. He had a history of side effects of gastrointestinal bleeding associated with use of NSAIDs and accompanied with femoral vein thrombosis and inguinal subcutaneous hematoma caused by percutaneous femoral vascular catheterization. The hematoma increased in size and was treated using JDI. In the present case, pain, venous thrombosis, and subcutaneous hematoma surprisingly improved with use of JDI in addition to combination therapy with anticoagulant (warfarin potassium) and antibiotic (meropenem hydrate), without using analgesics such as NSAIDs.ConclusionsThe present case indicated as follows: JDI controls the pain associated with hematoma without analgesics such as NSAIDs; JDI also has an effect of improving the complications associated with venous thrombosis and subcutaneous hematoma caused by catheterization in HD patients safely. JDI, one of Kampo drugs, has few side effects and can be used as needed.

Highlights

  • The authors report a case of pain, femoral vein thrombosis, and inguinal subcutaneous hematoma caused by percutaneous femoral vascular catheterization in a hemodialysis (HD) patient complicated with vascular access occlusion

  • The present case indicated as follows: JDI controls the pain associated with hematoma without analgesics such as non-steroidal antiinflammatory drugs (NSAIDs); JDI has an effect of improving the complications associated with venous thrombosis and subcutaneous hematoma caused by catheterization in HD patients safely

  • Conservative treatment of hematoma is acceptable if no hemodynamic dysfunction is present; no compartment syndrome is present; pain control is well-managed by analgesic drugs such as non-steroidal anti-inflammatory drugs (NSAIDs); and the hematoma does not increase in size

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Summary

Conclusions

The present case indicated as follows: JDI controls the pain associated with hematoma without analgesics such as NSAIDs; JDI has an effect of improving the complications associated with venous thrombosis and subcutaneous hematoma caused by catheterization in HD patients safely.

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