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Bilateral iliopsoas hematomas under sedation: a complication of postoperative therapy after coronary artery bypass

Dai Une1, Shuji Shimizu, Koji Nakanishi

  • 1Department of Cardiovascular Surgery, Saiseikai Imabari Hospital, Imabari, Ehime 799-1592, Japan. daune@hotmail.co.jp

Acta Medica Okayama
|March 5, 2010
PubMed

Insights

Postoperative iliopsoas hematomas can occur after coronary artery bypass grafting (CABG). Suspect retroperitoneal hematoma in sedated patients with unexplained anemia and shock during anticoagulant therapy.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Radiology

Background:

  • Coronary artery bypass grafting (CABG) is a common cardiovascular procedure.
  • Postoperative management often involves anticoagulant and antiplatelet therapies.
  • Sedation is frequently used for patient comfort and management.

Observation:

  • An 81-year-old woman developed sudden anemia and shock post-CABG.
  • The patient was receiving anticoagulant and antiplatelet medications under sedation.
  • Abdominal ultrasonography revealed a right retroperitoneal hematoma.

Findings:

  • Iliopsoas hematomas can present atypically in sedated patients.
  • Localizing symptoms like abdominal pain or femoral neuropathy may be absent.
  • Retroperitoneal hematoma was diagnosed via ultrasonography.

Implications:

  • Clinicians should consider retroperitoneal hematoma in sedated patients on anticoagulation with unexplained anemia/shock.
  • Prompt diagnostic imaging, such as ultrasonography, is crucial.
  • Conservative management can be effective for iliopsoas hematomas.

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