• Yong Luo, Qing Li, Zhanchen Liao, and Zhigang Luo.
• Hengyang Medical School, University of South China; Trauma Centre & Emergency Department, The Second Affiliated Hospital of the University of South China, Hengyang, P.R. China.
• Medicine (Baltimore). 2024 Feb 2; 103 (5): e33765e33765.

RationaleRetroperitoneal hematomas are relatively common in patients undergoing nephrectomy. Herein, we report an unusual case involving a giant retroperitoneal hematoma and subsequent duodenal ulcerative bleeding following a radical nephrectomy.Patient ConcernsA 77-year-old woman was admitted to our hospital for lower back pain, and she had severe right hydronephrosis and a urinary tract infection.DiagnosesThe patient was diagnosed and confirmed as high-grade urothelial carcinoma.InterventionsAfter ineffective conservative treatments, a right radical nephrectomy and ureteral stump resection were performed. The patient received proton pump inhibitors to prevent stress ulcer formation and bleeding. On the first day post-surgery, she had normal gastrointestinal (GI) endoscopy findings. On the second day post-surgery, abdominal computed tomography revealed a retroperitoneal hematoma. Notably, 14 days post-surgery, massive GI bleeding occurred, and GI endoscopy identified an almost perforated ulcer in the bulbar and descending duodenum.OutcomesThe patient died on day 15 after surgery.LessonsDuodenal ulceration and bleeding might occur following a retroperitoneal hematoma in patients treated with nephrectomy. Timely intervention may prevent duodenal ulcers and complications, and thus could be a promising life-saving intercession.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

31 keywords...

hide…