Spontaneous Retroperitoneal Bleeding in a Patient with Systemic Lupus Erythematosus

Background and Objectives: Systemic lupus erythematosus (SLE) is a disease with multiple organ involvement, and spontaneous hemorrhage, especially perirenal hemorrhage, is rare. Case Presentation: We report the case of a 19-year-old teenager with SLE who experienced left flank pain and hypovolemic s...

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Published inMedicina (Kaunas, Lithuania) Vol. 60; no. 1; p. 78
Main Authors Chen, Wei-Hung, Yang, Deng-Ho
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.01.2024
Subjects
Abdomen
abdominal pain
Adolescent
Adult
Anemia
Antibodies
Backache
bleeding
Blood coagulation factors
Care and treatment
Catheters
Creatinine
CT imaging
Embolization
Emergency medical care
Gastrointestinal Hemorrhage
Glycoproteins
Hematoma
Hematoma - complications
Hemodialysis
Hemorrhage
Hospitals
Humans
Ischemia
Kidney diseases
Laboratories
Laparotomy
Lupus
Lupus Erythematosus, Systemic - complications
Lupus Nephritis
Medical imaging
Mesentery
Pain
Patients
Review boards
Shock
Systemic lupus erythematosus
Tomography
Ultrasonic imaging
Veins & arteries
Young Adult
Taiwan
abdominal pain
systemic lupus erythematosus
bleeding
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Summary:Background and Objectives: Systemic lupus erythematosus (SLE) is a disease with multiple organ involvement, and spontaneous hemorrhage, especially perirenal hemorrhage, is rare. Case Presentation: We report the case of a 19-year-old teenager with SLE who experienced left flank pain and hypovolemic shock. Abdominal computed tomography revealed a large left retroperitoneal hematoma. Recurrent hypovolemic shock occurred despite the transcatheter arterial embolization of the left renal artery. Repetitive abdominal computed tomography results showed active hemorrhage. Result: An exploratory laparotomy was used to confirm descending colonic mesenteric artery bleeding, which was resolved. The patient needed temporary regular kidney replacement therapy for active lupus nephritis, which terminated one month after discharge. Conclusions: When patients with SLE experience acute abdominal pain, flank pain, or back pain combined with hypovolemia, there is a higher risk of bleeding due to spontaneous hemorrhage, which should be included in the differential diagnosis. Therefore, early diagnosis and adequate emergency intervention are necessary.
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ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina60010078