A Case of Spontaneous Bleeding from the Branch of Subclavian Artery in a Hemodialysis Patient.
- Author:
Chan Sun PARK
1
;
Shin Young LEE
;
Byeong Chool PARK
;
Jee In JEONG
;
Ho KIL
;
Eun Young CHOI
;
Soon Kil KWON
;
Hye Young KIM
Author Information
1. Division of Nephrology, Department of Internal Medicine, College of Medicine, Chungbuk National University, Korea. kwon@chungbuk.ac.kr
- Publication Type:Case Report
- Keywords:
Hemorrhage;
Hemodialysis;
Subclavian artery;
End-stage renal disease
- MeSH:
Angiography;
Catheters;
Central Venous Catheters;
Deamino Arginine Vasopressin;
Erythrocytes;
Erythropoietin;
Estrogens;
Female;
Hematoma;
Hemorrhage*;
Humans;
Kidney Failure, Chronic;
Mediastinum;
Middle Aged;
Peritoneal Dialysis;
Plasma;
Pleural Cavity;
Renal Dialysis*;
Subclavian Artery*;
Subdural Space;
Thoracic Wall
- From:Korean Journal of Nephrology
2007;26(6):792-796
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In patients undergoing hemodialysis, spontaneous bleedings have been reported in locations such as mediastinum, subdural space, retroperitoneum, pericardial and pleural cavities. A 61 year-old woman had been treated three times a week with maintenance hemodialysis via tunnelled cuffed central venous catheter for 4 months. She had a sudden onset of severe pain on right chest wall 24 hours after maintenance hemodialysis. We found that her right upper chest wall was swollen. Urgent computed tomography revealed a soft tissue mass with high density in right chest wall. The lesion was enhanced by contrast but was not clearly marginated in arterial phase. We did emergent hemodialysis, and did transfusion of packed red blood cells and fresh frozen plasma and compressed locally on her right chest wall. Hematoma was spontaneously resolved only after supportive care. Therapeutic approaches to uremic patients with bleeding disorders include angiography, hemodialysis, peritoneal dialysis, transfusion of packed red cells and fresh frozen plasma, infusion of erythropoietin, desmopressin, conjugated estrogen, etc. In this case, spontaneous bleeding without trauma history can occur in patients with endstage renal disease who underwent hemodialysis using catheter. Therefore, immediate treatment should be followed when evidence of bleeding is found.
