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Retroperitoneal hemorrhage following bone marrow biopsy
1II Division of Medicine, General Hospital, Legnano, Italy.
Haematologica
|January 1, 1994
Summary
A bone marrow biopsy in an elderly patient with polycythemia vera led to retroperitoneal hemorrhage due to needle injury of the iliolumbar artery.
Area of Science:
- Hematology
- Interventional Procedures
- Vascular Anatomy
Background:
- Polycythemia vera is a myeloproliferative neoplasm characterized by increased red blood cell mass.
- Bone marrow biopsy is a common diagnostic procedure for hematological disorders.
- Iliolumbar artery is a significant branch of the internal iliac artery, supplying the pelvic region.
Observation:
- An elderly female patient diagnosed with polycythemia vera underwent a bone marrow biopsy.
- During the procedure, the biopsy needle inadvertently penetrated the iliac crest.
- This penetration caused direct trauma to the iliolumbar artery.
Findings:
- The direct needle trauma resulted in a significant retroperitoneal hemorrhage.
- The injury specifically involved the iliolumbar artery, a branch of the hypogastric artery.
- This complication highlights a rare but serious risk associated with bone marrow biopsy.
Implications:
- This case underscores the importance of meticulous technique during bone marrow biopsy, especially in patients with potential bleeding risks.
- Awareness of pelvic vascular anatomy is crucial to prevent iatrogenic injuries.
- Prompt recognition and management of retroperitoneal hemorrhage are vital for patient outcomes.