UOTW #32

The patient is a 39 y/o female with a h/o lupus who is post-op day #7 status-post renal transplant.  The patient complains of abdominal pain with gross hematuria for several days. Upon arrival, the patient’s initial vitals were a BP of 137/59 and a pulse of 91.  Examination showed cold extremities, moderate diffuse abdominal tenderness/distension and a pale tongue.

I-stat hematocrit was noted to be 5, and so the patient was given 4 units of pRBCs and surgery was consulted.  Suddenly the patient becomes unresponsive in front of you, and you are unable to palpate any pulses.  Standard ACLS was followed and the patient obtained ROSC. Repeat abdominal scan showed the following.

Answer

3 thoughts on “UOTW #32

  1. Perinephric collection mostly hematoma, that progreesed into free fluid in abdomen.. The cause may be ruptured renal artery or Ao dissection

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