Abstract
Spontaneous retroperitoneal hematoma is a rare clinical entity that is most commonly caused by renal tumors and vascular disease. In this article, we present a case of spontaneous retroperitoneal hemorrhage caused by polyarteritis nodosa in a patient who presented with severe left flank pain. He underwent computed tomography angiography of his abdomen that showed left retroperitoneal hematoma, which was followed by arteriogram that showed multiple bilateral renal artery aneurysms with active extravasation, findings consistent with polyarteritis nodosa. The patient underwent successful coiling of the bleeding vessel that secured the bleeding and was started on high-dose prednisone, which resulted in resolution of his symptoms.
Highlights
Our patient is a 67-year-old gentleman with past medical history significant for hypertension, diabetes mellitus type 2, and chronic obstructive pulmonary disease, who presented to our emergency department with sudden onset of severe left flank pain
Computed tomography (CT) scan of his abdomen and pelvis was obtained, which showed large acute retroperitoneal hematoma extending into the left suprarenal fossa and left hemi pelvis anteriorly displacing the left renal parenchyma (Figures 1 and 2)
Interventional radiology was consulted who did an arteriogram that showed multiple bilateral renal artery aneurysms (Figures 3 and 4) and active extravasation present from L2 segmental artery trunk, findings consistent with polyarteritis nodosa (PAN), which was embolized that secured the bleeding, and the patient was started on prednisone 60 mg daily
Summary
Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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