Spontaneous retroperitoneal hematoma after COVID-19 infection: A case report.

IF 1.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Xi Chen, Zheng Li, Liangping Zou, Yupin Lan, Xiaoling Wu, Hui Wang
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引用次数: 0

Abstract

Rationale: Spontaneous retroperitoneal hematoma (SRH) is a rare but potentially fatal condition, often associated with anticoagulation therapy. With the global prevalence of COVID-19 and the widespread use of anticoagulants in its management, there is an increasing need to recognize rare but serious complications like SRH. This case report aims to emphasize the importance of early recognition and intervention of SRH in patients with COVID-19 undergoing anticoagulation therapy, to improve patient outcomes and reduce mortality.

Diagnoses: An 86-year-old male with a history of COVID-19 presented with recurrent cough, hemoptysis, and fever. Initial treatment included antiviral and anticoagulant therapy. The patient later developed abdominal distension, pain, and eventually hypovolemic shock, leading to the diagnosis of SRH confirmed by imaging and a significant drop in hemoglobin levels.

Interventions: The patient received comprehensive supportive care, including noninvasive ventilation, antiviral therapy, and anticoagulants. Upon the onset of SRH, emergency interventions included fluid resuscitation, vasopressors, and interventional embolization of the bleeding vessels.

Outcomes: The patient initially responded well to COVID-19 treatment but developed SRH, which was managed successfully with interventional embolization. Post-procedure, the patient's vital signs stabilized, hemoglobin levels gradually increased without the need for further transfusions, and he regained full consciousness. Over the following weeks, the patient showed continuous improvement, with resolution of abdominal pain and a return to baseline mobility. He was discharged in stable condition with scheduled follow-ups.

Lessons: This case underscores the critical need for vigilance in monitoring patients on anticoagulation therapy, particularly those with COVID-19, for signs of SRH. Early recognition and prompt intervention are essential to improve outcomes. Clinicians should maintain a high index of suspicion for SRH in patients presenting with unexplained abdominal pain and hypovolemic shock, even in the absence of typical risk factors.

COVID-19感染后自发性腹膜后血肿1例。
理由:自发性腹膜后血肿(SRH)是一种罕见但潜在致命的疾病,通常与抗凝治疗有关。随着COVID-19的全球流行和抗凝血剂在其管理中的广泛使用,越来越需要认识到罕见但严重的并发症,如SRH。本病例报告旨在强调在接受抗凝治疗的COVID-19患者中早期识别和干预SRH的重要性,以改善患者预后,降低死亡率。诊断:86岁男性,有新冠肺炎病史,表现为反复咳嗽、咯血、发热。最初的治疗包括抗病毒和抗凝治疗。患者随后出现腹胀、疼痛,最终出现低血容量性休克,影像学证实为SRH,血红蛋白水平明显下降。干预措施:患者接受全面的支持治疗,包括无创通气、抗病毒治疗和抗凝治疗。在SRH发病后,紧急干预包括液体复苏、血管加压剂和介入栓塞出血血管。结果:患者最初对COVID-19治疗反应良好,但发生了SRH,并通过介入栓塞成功治疗。术后,患者生命体征稳定,血红蛋白水平逐渐升高,无需进一步输血,患者完全恢复意识。在接下来的几周内,患者表现出持续的改善,腹痛缓解,恢复到基线活动能力。出院时病情稳定,并安排随访。经验教训:该病例强调了在监测抗凝治疗患者,特别是COVID-19患者的SRH迹象时保持警惕的关键必要性。早期识别和及时干预对改善预后至关重要。临床医生应该对出现不明原因腹痛和低血容量性休克的患者保持高度怀疑,即使没有典型的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medicine
Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
4342
审稿时长
>12 weeks
期刊介绍: Medicine is now a fully open access journal, providing authors with a distinctive new service offering continuous publication of original research across a broad spectrum of medical scientific disciplines and sub-specialties. As an open access title, Medicine will continue to provide authors with an established, trusted platform for the publication of their work. To ensure the ongoing quality of Medicine’s content, the peer-review process will only accept content that is scientifically, technically and ethically sound, and in compliance with standard reporting guidelines.
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