Inestabilidad hemodinámica debida a hematoma mamario en mujer anticoagulada

Abstract

BackgroundEmergencies in breast disease are rare, the most common being mastitis and abscesses. Breast haematomas, despite their low frequency, may require urgent therapeutic management. Case reportWe present the case of a 74-year-old woman, receiving anticoagulation with acenocumarol due to a chronic atrial fibrillation, who presented to the local emergency department after having a sensation of clicking and pain in the pectoral region following right arm extension, accompanied by progressive growth of the ipsilateral breast. Physical examination revealed haemodynamic instability and a large haematoma in the right breast extending to the lateral chest wall. After stabilizing the patient and correcting the coagulation, an unsuccessful failed attempt was made to embolize the bleeding vessel. Finally, the patient underwent surgical drainage of a large hematoma. ConclusionLarge breast haematomas causing haemodynamic instability should be drained surgically, without prior attempts at conservative measures.