Post Ureteroscopy peri renal hematoma leading to diagnosis of hemophilia and angiodyslasia colon- A rare clinical cluster.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 12
Abstract
Ureterorenoscopy is a common procedure, but there have been complications reported with it. Twenty eight year old male, previously diagnosed case of chronic kidney disease(CKD) with hypertension underwent ureterorenoscopy for upper ureteric calculus. He presented with a tender immobile lump in right flank on post operative day two which was a 14 cm organized hematoma on computerized tomography(CT). On post operative day four, he developed massive bleed per rectally. CT angiography was suggestive of angiodysplasia of ascending colon and underwent emergency right hemicolectomy for the same. On hematological workup, the patient was found to have Factor VIIIc deficiency (mild hemophilia). Our patient was hypertensive and known case of CKD which made him susceptible to perirenal hematoma. It is known to occur in patients of bleeding disorders like Chronic Idiopathic Thrombocytopenic Purpura. However, post operative hematoma occurring in a case of mild hemophilia has never been mentioned in literature. Angiodysplasia of colon has been associated with Von will brands disease, almost exclusively with a few subtypes. However its association with hemophilia has not been reported till date. Thus surgeons should be vigilant about hemorrhagic complications in hypertensive patients affected with CKD. Also hematological disorders should be kept in mind when dealing with hemorrhagic complications.
Authors and Affiliations
Dr. Varun V Agarwal
Keywords
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