A case of acute abdomen with perirenal hematoma in a patient undergoing hemodialysis

Abstract

This report presents the case of a 56-year-old male patient who had received maintenance hemodialysis for 7 years. The patient experienced a sudden decrease in blood pressure and right acute abdomen during hemodialysis. CT revealed a massive right perirenal hematoma. A right hemorrhage was diagnosed and the patient was treated by transcatheter arterial embolization (TAE). There was remission of the abdominal pain the next day. The patient was discharged on postoperative day 16. CT showed that the perirenal hematoma was reduced after three months. Perirenal hematoma can be caused by trauma, renal cancer, or renal cyst, among others. Drugs were suspected to have been the cause of the hematoma in the current case because the patient had been taking aspirin following CABG (coronary artery bypass graft). It is important to be aware that a differential diagnosis of acute abdomen in maintenance hemodialysis patients is renal hemorrhage. Patients should be followed up by CT to rule out malignancy.