2003 Volume 23 Issue 6 Pages 939-943
It is difficult to diagnose retroperitoneal hematoma in the early stage. It is also rare that retroperitoneal hematoma occurs with symptoms of shock. A 71-year-old man was admitted to our hospital with chest pain. He was diagnosed as having acute myocardial infarction, and underwent percutaneous transluminal coronary angioplasty (PTCA). Ten hours later, his blood pressure decreased. We could not recognize any subcutaneous hematoma around the puncture site, and the patient did not have any particular symptom. Abdominal computed tomography revealed a giant retroperitoneal hematoma. The laboratory data showed anemia. Anti-coagulation therapy was discontinued and a blood transfusion was perfomed. We waited until the patient's general condition stabilized and perfomed an operation. Intraoperative findings nevealed that blood had leaked into the femoral vessel sheath from the puncture site and flowed into the retroperitoneal space. We should recognize that, even after appropriate cardiac catheterization or PTCA, retroperitoneal hematoma can still occur accompanied with shock.
