Three cases of spontaneous lumbar artery rupture in hemodialysis patients.
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.
Department of Internal Medicine & Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Na Kyoung
NK
Hwang
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.
Harin
H
Rhee
Department of Internal Medicine & Research Institute for Convergence of Biomedical Science and Technology, Yangsan Pusan National University Hospital, Yangsan, Korea.
Il Young
IY
Kim
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.
Eun Young
EY
Seong
Department of Internal Medicine & Research Institute for Convergence of Biomedical Science and Technology, Yangsan Pusan National University Hospital, Yangsan, Korea.
Dong Won
DW
Lee
Department of Internal Medicine & Research Institute for Convergence of Biomedical Science and Technology, Yangsan Pusan National University Hospital, Yangsan, Korea.
Soo Bong
SB
Lee
Department of Internal Medicine & Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Ihm Soo
IS
Kwak
Department of Radiology & Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Chang Won
CW
Kim
Department of Internal Medicine & Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Sang Heon
SH
Song
D000328:Adult; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008161:Lumbosacral Region / Q000098:blood supply*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D012422:Rupture, Spontaneous / Q000209:etiology*
Anticoagulant; hemodialysis; lumbar artery; spontaneous retroperitoneal hematoma