Life-threatening retroperitoneal hematoma caused by anticoagulant therapy for myocardial infarction after SWL.
Extracorporeal shock wave lithotripsy, the primary treatment for renal and ureteral stones, is an elective procedure with a low rate of complications, although most patients have macrohematuria which lasts for a few hours, and as many as 25% develop a renal or perirenal hematoma. Therefore, SWL is not performed during anticoagulant therapy, and any blood dyscrasias should be corrected prior to the procedure. We present a case of a patient who had an acute myocardial infarction after SWL, was treated with anticoagulation and emergency coronary angioplasty, and subsequently developed a life-threatening retroperitoneal hemorrhage. Cessation of anticoagulation with fluid support and drainage of a pleural effusion eventually resulted in complete recovery.
Katz
R
R
Department of Urology, Hadassah University Hospital, Jerusalem, Israel.
Admon
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D
Pode
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D017130:Angioplasty; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D004562:Electrocardiography; D005500:Follow-Up Studies; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000628:therapy; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010532:Peritoneal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D011859:Radiography; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging; D014463:Ultrasonography
D000925:Anticoagulants; D006493:Heparin