Flank Pain, Nausea, Vomiting and Hypotension in a Chronic Hemodialysis Patient with a Spontaneous Perirenal Hemorrhage

Yusuke Igarashi; Tetsu Akimoto; Akinori Nukui; Hiroyasu Nakamura; Akira Kawai; Shigeyoshi Kijima; Taro Kubo; Hideharu Sugimoto; Tatsuo Morita; Eiji Kusano

doi:10.2169/internalmedicine.52.0242

CASE REPORTS

Flank Pain, Nausea, Vomiting and Hypotension in a Chronic Hemodialysis Patient with a Spontaneous Perirenal Hemorrhage

Yusuke Igarashi, Tetsu Akimoto, Akinori Nukui, Hiroyasu Nakamura, Akira Kawai, Shigeyoshi Kijima, Taro Kubo, Hideharu Sugimoto, Tatsuo Morita, Eiji Kusano

Author information

Yusuke Igarashi
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Tetsu Akimoto
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Akinori Nukui
Department of Urology, Jichi Medical University, Japan
Hiroyasu Nakamura
Department of Radiology, Jichi Medical University, Japan
Akira Kawai
Department of Radiology, Jichi Medical University, Japan
Shigeyoshi Kijima
Department of Radiology, Jichi Medical University, Japan
Taro Kubo
Department of Urology, Jichi Medical University, Japan
Hideharu Sugimoto
Department of Radiology, Jichi Medical University, Japan
Tatsuo Morita
Department of Urology, Jichi Medical University, Japan
Eiji Kusano
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan

Keywords: perirenal hemorrhage, hemodialysis, hypotension, Wunderlich syndrome

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 18 Pages 2083-2086

DOI https://doi.org/10.2169/internalmedicine.52.0242

Details

Abstract

Decreases in blood pressure develop in response to a wide range of clinical disorders. Various factors have been implicated in the development of hemodialysis-associated hypotension, including an impairment of the compensatory processes, an autonomic dysfunction or cardiac failure. The additional presence of concomitant acute abdomen may result in a diagnostically challenging situation. We herein report our experience with a chronic hemodialysis patient who developed severe hypotension with acute flank pain due to spontaneous bleeding around the kidney. Concerns regarding the management of the disease are also discussed.

Corresponding author

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