%0 Journal Article
%T Bilateral spontaneous retroperitoneal bleeding in a patient on nimesulide: a case report
%A Iraklis C Mitsogiannis
%A Eleftherios Chatzidarellis
%A Andreas Skolarikos
%A Athanasios Papatsoris
%A Georgia Anagnostopoulou
%A Evangelos Karagiotis
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-568
%X A 50-year-old Greek man, who was on a non-steroidal anti-inflammatory agent (nimesulide) for ankylosing spondylitis, presented with a right retroperitoneal hematoma combined with contralateral subcapsular renal hematoma. Bleeding on his right side was successfully controlled by arterial embolization with coils, whereas the left renal hematoma was treated conservatively. His recovery period was uneventful.This is the first reported case of bilateral retroperitoneal bleeding in a patient receiving nimesulide for ankylosing spondylitis. The application of minimally invasive techniques resulted in the desired positive outcome with preservation of both renal units.Spontaneous retroperitoneal bleeding is a rare event which can potentially be life-threatening. The majority of cases are due to ruptured renal lesions (such as angiomyolipomas); however, vascular disorders and anticoagulation therapy may also be the underlying cause. Presenting symptoms and clinical signs depend on the degree and duration of bleeding and therefore may vary significantly. We report a case of spontaneous bilateral retroperitoneal hematoma in a patient on nimesulide for ankylosing spondylitis.A 50-year-old Greek man presented at our Accidents and Emergency Department with acute right flank pain and gross hematuria of three-hour duration. Our patient reported no trauma, renal disease or coagulation disorder but had a history of ankylosing spondylitis for which he had received various courses of methylprednisolone and non-steroidal anti-inflammatory agents (NSAIDs) in the past; at the time of presentation our patient was on nimesulide, a selective cyclooxygenase-2 (COX-2) inhibitor. A clinical examination disclosed abdominal tenderness on the right, tachypnoea, low arterial pressure and tachycardia. A laboratory evaluation revealed severe anemia (hematocrit, 15%). A computerized tomography (CT) scan of his chest and abdomen demonstrated an extensive right retroperitoneal hematoma combined with a su
%U http://www.jmedicalcasereports.com/content/5/1/568