Delayed retroperitoneal hemorrhage during veno-venous extracorporeal membrane oxygenation: a case report.

Abstract

CASE:

There are several reports of retroperitoneal hemorrhage induced by percutaneous femoral cannulation for extracorporeal membrane oxygenation (ECMO). However, there are no reports of delayed retroperitoneal hemorrhage, which develops a few days after ECMO initiation and is unrelated to the ECMO cannulation. Herein, we report a rare case of delayed retroperitoneal hemorrhage during veno-venous extracorporeal membrane oxygenation (VV-ECMO).

OUTCOME:

A 54-year-old man was referred to our hospital because of severe acute respiratory distress syndrome. We initiated VV-ECMO. The patient had severe delirium and was confined to a long-term supine position to maintain circuit safety. On day 13, computed tomography unexpectedly revealed a large retroperitoneal hemorrhage spreading around the psoas muscle.

CONCLUSION:

Delayed retroperitoneal hemorrhage can develop during VV-ECMO management a few days after its initiation. Anticoagulant use and forceful muscular strain could be risk factors of delayed retroperitoneal hemorrhage.

• Authors: Gaku Sugiura, Naofumi Bunya, Ayumu Yamaoka, Hiroki Okuda, Masato Saito, Hirotoshi Mizuno, Hiroyuki Inoue, Eichi Narimatsu
• Journal: Acute medicine & surgery (Acute Med Surg) Vol. 6 Issue 2 Pg. 180-184 (Apr 2019) ISSN: 2052-8817 [Electronic] United States
• PMID: 30976445 (Publication Type: Case Reports)