Clinical Cases Of Retroperitoneal Hematoma In Old Age – Our Experiences
2019
Introduction: As life expectancy gets longer the prevalence of cardiovascular diseases which require an anticoagulant drug therapy increases. Old people are of higher risk of evolving side effects (bleeding in particular) than the middle-aged population. Bleeding in the retroperitoneal space represents the life-threatening status and increases morbidity and mortality of patients. Methods: We present five cases of retroperitoneal bleeding while the coagulant drugs were administered – warfarin or low molecular weight heparin. There was not found any history of falls or injuries in recent period (30 days) before the occurence of bleeding. Results: All of our diseased were affected by significant polymorbidity. In one case the senior patient was admitted for the retroperitoneal hematoma, in the rest of the cases the bleeding was discovered during the institutionalization. In all cases we diagnosed bleeding in the retroperitoneal space with the impairment of the right or left iliopsoas muscle, alternatively perirenal space. Four of our diseased were treated conservatively adjusting the coagulation panels, one was treated surgically. Four patients survived and one patient deceased. Conclusion: The resolution of retroperitoneal bleeding in seniors should be strictly individual guided by a multidisciplinary medical team. Comorbidities, age, ability and frailty of the patient should be considered in each case. In the course of acute decompensation of internal diseases the coagulation blood test should be performed more frequently while administering the anticoagulants.
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