title: Flank pain, nausea, vomiting and hypotension in a chronic hemodialysis patient with a spontaneous perirenal hemorrhage.
abstract: Decreases in blood pressure develop in response to a wide range of clinical disorders. Various factors have been implicated in the development of hemodialysis-associated hypotension, including an impairment of the compensatory processes, an autonomic dysfunction or cardiac failure. The additional presence of concomitant acute abdomen may result in a diagnostically challenging situation. We herein report our experience with a chronic hemodialysis patient who developed severe hypotension with acute flank pain due to spontaneous bleeding around the kidney. Concerns regarding the management of the disease are also discussed.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Tetsu
authors.initials: T
authors.lastname: Akimoto
authors.forename: Akinori
authors.initials: A
authors.lastname: Nukui
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Kijima
authors.forename: Taro
authors.initials: T
authors.lastname: Kubo
authors.forename: Hideharu
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Morita
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusano
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000368:Aged; D004621:Embolization, Therapeutic; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D021501:Flank Pain / Q000209:etiology*; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009325:Nausea / Q000209:etiology; D009392:Nephrectomy; D006435:Renal Dialysis / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000209:etiology