Abstract
BackgroundWe experienced four Japanese patients with spontaneous retroperitoneal bleeding, a rare disease. We categorized the clinical characteristics of spontaneous retroperitoneal bleeding in these patients treated in our hospital and discuss the risk factors of spontaneous retroperitoneal bleeding.Case presentationThree of the 4 patients did not have a bleeding tendency as indicated by laboratory data obtained at the time of retroperitoneal bleeding. The causative blood vessels were the lumbar and superior gluteal arteries and the internal iliac artery. All patients were receiving an anticoagulant, heparin in one and nafamostat mesilate in the other three patients. Three patients were being treated with hemodialysis or continuous hemodiafiltration when the spontaneous retroperitoneal bleeding occurred. We achieved hemostasis with transcatheter arterial embolization in 3 patients and with surgical hemostasis in 1 patient.ConclusionsWe suggest that in patients receiving anticoagulant therapy in whom progressive anemia and unstable vital signs are present, spontaneous retroperitoneal bleeding should be considered as a possible cause. Nafamostat mesilate may be one of the risk factors for spontaneous retroperitoneal bleeding.
Highlights
We experienced four Japanese patients with spontaneous retroperitoneal bleeding, a rare disease
We suggest that in patients receiving anticoagulant therapy in whom progressive anemia and unstable vital signs are present, spontaneous retroperitoneal bleeding should be considered as a possible cause
We categorize the clinical characteristics of Spontaneous retroperitoneal bleeding (SRB) in these patients and discuss the risk factors for SRB
Summary
We suggest that SRB should be considered as a possible complication in patients receiving anticoagulant therapy in whom progressive anemia and unstable vital signs are present. Nafamostat mesilate may be one risk factor for SRB. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions HY participated in study design and in data collection and interpretation and drafted the manuscript. TM, TY, KK, and YM participated in data collection. HY had a major impact on the interpretation of data and critical appraisal of the manuscript. All authors participated in the writing and review of the manuscript. All authors read and approved the final manuscript
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