Endovascular management of a case of spontaneous retroperitoneal haematoma complicated with deep vein thrombosis and pulmonary embolism

BMJ Case Rep. 2017 Dec 1:2017:bcr2017222217. doi: 10.1136/bcr-2017-222217.

Abstract

Spontaneous retroperitoneal haematoma (SRH) can be a life-threatening emergency presenting with hypovolaemic shock. SRH has been rarely reported with May-Thurner syndrome (MTS) where it occurs due to rupture of the iliac vein or venous collaterals. We report a case of MTS that presented with deep venous thrombosis of the left lower limb complicated by bilateral pulmonary embolism (PE) and a large pelvic haematoma. The simultaneous occurrence of a large pelvic haematoma and PE offered a therapeutic challenge. Successful endovascular management of the case is discussed in this report.

Keywords: cardiovascular medicine; interventional cardiology; venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Aftercare
  • Computed Tomography Angiography / methods
  • Diagnosis, Differential
  • Endovascular Procedures / methods
  • Factor Xa Inhibitors / therapeutic use
  • Female
  • Hematoma / complications*
  • Hematoma / drug therapy
  • Hematoma / pathology
  • Hematoma / surgery*
  • Humans
  • Lower Extremity / blood supply*
  • Lower Extremity / diagnostic imaging
  • Lower Extremity / pathology
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Peritoneum / blood supply*
  • Peritoneum / diagnostic imaging
  • Peritoneum / pathology
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / etiology*
  • Pyrazoles / administration & dosage
  • Pyrazoles / therapeutic use
  • Pyridones / administration & dosage
  • Pyridones / therapeutic use
  • Stents / standards
  • Thrombolytic Therapy / instrumentation*
  • Treatment Outcome
  • Ultrasonography / methods
  • Ultrasonography, Doppler / methods
  • Venous Thrombosis / etiology

Substances

  • Factor Xa Inhibitors
  • Pyrazoles
  • Pyridones
  • apixaban