Intractable gross hematuria without an obvious or common urologic pathology needs more effort for correct diagnosis and appropriate management. In this case, we report on a patient with intractable hematuria originating from varicose vessels of urinary bladder due to advanced venous stasis after severe cardiac failure.
A 66-year-old male was consulted for massive hematuria and clot retention subsequent to urethral catheterization after admission into intensive care unit because of cardiac decompensation. His medical history revealed cardiomyopathy and aortic metallic valve replacement 20 years ago and gout disease for 25 years. He had been on oral anticoagulation with warfarin for 20 years. On physical examination severe ascites and pulmonary effusion, and extensive venous stasis in lower trunk was found. Central venous pressure was 30 cmH2O. His blood biochemistry work-up revealed moderate hyponatremia (132 meq/L) and a serum creatinin of 2.6 mg/dl (normal 0.5 to 1.4). Anticoagulation was terminated at first. Prothrombin time / INR level returned within normal limits following cessation of warfarin and he had only mild anemia.
Published on: May 18, 2016 Pages: 11-12
Jose Manuel Ramia-Angel
Guadalajara University Hospital , Spain
Journal of Surgery and Surgical Research
Samy I. McFarlane
State University of New York, Downstate Medical Centre, Brooklyn, New York, USA
International Journal of Clinical Endocrinology and Metabolism
Metaxas Memorial Anticancer Hospital , Greece
Annals of Bone Marrow Research
Hon. Pierre Guertin
Laval University, Canada
Global Journal of Obesity, Diabetes and Metabolic Syndrome
University of Athens, Greece
Journal of Novel Physiotherapy and Physical Rehabilitation