Hwang Na Kyoung, Rhee Harin, Kim Il Young, Seong Eun Young, Lee Dong Won, Lee Soo Bong, Kwak Ihm Soo, Kim Chang Won, Song Sang Heon
Department of Internal Medicine & Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Radiology & Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Hemodial Int. 2017 Jan;21(1):E18-E21. doi: 10.1111/hdi.12491. Epub 2016 Sep 26.
We encountered three cases of retroperitoneal hematoma caused by spontaneous lumbar artery rupture, a rare vascular complication. At the time of retroperitoneal hematoma, two patients were on anticoagulant/antiplatelet therapy. One patient was not taking any anticoagulant/antiplatelet agents but was receiving hemodialysis treatment with heparin. Lumbar artery rupture was successfully controlled by transcatheter arterial embolization in all patients, but one patient developed multiple organ failure and died. We suggest that spontaneous lumbar artery rupture may occur in patients being treated with maintenance hemodialysis or anticoagulant/antiplatelet therapy. Therefore, clinicians should suspect lumbar artery rupture in patients with unstable vital signs and rapid onset of anemia because early diagnosis and appropriate intervention are necessary to decrease the risks of morbidity and mortality.
我们遇到了3例由自发性腰动脉破裂引起的腹膜后血肿，这是一种罕见的血管并发症。发生腹膜后血肿时，2例患者正在接受抗凝/抗血小板治疗。1例患者未服用任何抗凝/抗血小板药物，但正在接受肝素血液透析治疗。所有患者均通过经导管动脉栓塞成功控制了腰动脉破裂，但1例患者发生多器官功能衰竭并死亡。我们建议，接受维持性血液透析或抗凝/抗血小板治疗的患者可能发生自发性腰动脉破裂。因此，临床医生应对生命体征不稳定且贫血迅速出现的患者怀疑腰动脉破裂，因为早期诊断和适当干预对于降低发病率和死亡率风险是必要的。
