[Splenic subcapsular hematoma and long-term hemodialysis]

Area of Science:

• Nephrology
• Hematology
• Radiology

Background:

• Patients with chronic kidney disease on maintenance hemodialysis exhibit an elevated risk of spontaneous bleeding.
• Hemorrhagic complications in this population can manifest in various locations, including the retroperitoneal space, liver, kidneys, and central nervous system.

Observation:

• Two patients on chronic hemodialysis presented with subcapsular splenic hematomas.
• Diagnostic imaging, including sonography and computed tomography (CT) scans, confirmed the presence of these hematomas.

Findings:

• Conservative management, involving low-dose heparin, bed rest, and close monitoring, was implemented for both patients.
• Serial ultrasound and CT scans documented complete resolution of the splenic hematomas within 2 and 4 months, respectively.

Implications:

• Conservative management can be effective for splenic subcapsular hematomas in hemodialysis patients.
• This approach may obviate the need for more invasive interventions, highlighting the importance of careful monitoring and tailored treatment strategies.