Abstract

RODRIGUEZ COLLAR, Tomás Lázaro et al. Spontaneous renal sub-capsular hematoma after the use of antiplatelet. Rev Cub Med Mil [online]. 2014, vol.43, n.2, pp. 249-257. ISSN 0138-6557.

A case of a 65 year-old male patient with a history of having received a coronary stent and antiplatelet therapy with Aspirin^® and Clopidogrel^® is presented here. He complained of pain in the right flank and iliac fossa nausea and vomiting 21 days after the procedure. At initial physical examination, normal vital signs but pain and increased volume in the aforementioned areas were detected. Abdominal ultrasound revealed well defined right perirenal collection and normal size kidneys and echotexture. Computed tomography showed the presence of a right subcapsular renal image with liquid density and extrinsic compression of a structurally normal kidney. The day after admission the patient ran a fever of 38 ^oC. Antiplatelet therapy was discontinued and lumbotomy and drainage of the hematoma was performed 7 days latter; about 400 mL of brownish blood was obtained. The patient progressed satisfactorily. It is concluded that spontaneous subcapsular renal hematoma is a rare complication of antiplatelet requiring multidisciplinary management.Computed tomography imaging is required for diagnosis. The renal compression due to its large size as well as pain and fever, justify their surgical drainage.

Keywords : kidney; acute abdomen; spontaneous retroperitoneal hemorrhage; renal subcapsular hematoma; complications from antiplatelet agents.

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