ANTICOAGULANT INDUCED SUBMUCOSAL HEMORRHAGE MIMICKING A RENAL PELVIC TUMOR

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A 73-year-old woman presented with gross hematuria and slight lumbago in June 1998. She had been on oral warfarin potassium for 4 years because of a permanent pacemaker implantation for the sick sinus syndrome. IVP revealed irregular right caliceal and pelvic defects, and narrowing of the infundibula. The left kidney was slightly hydronephrotic due to ureteropelvic junction stenosis. Abdominal computerized tomography (CT) showed thickening of the bilateral renal pelvic wall and the vestibule in the stomach with a slight homogeneous enhancement, which was considered suspiciously similar to bilateral renal pelvic and gastric tumors, or a malignant lymphoma (part A of figure). However, photogastroscopy did not reveal a stomach tumor. Repeat abdominal CT failed to show bilateral renal pelvic or gastric tumor. However, a hematoma was evident between the left gluteus medius and gluteus minimus (part B of figure). A thrombotest revealed less than 10% of normal value (normal during therapy 10% to 20%). We concluded that bilateral renal pelvic wall thickening was allowing hemorrhaging into the submucosa.

収録刊行物

  • Journal of Urology

    Journal of Urology 163 231-231, 2000-01-01

    Ovid Technologies (Wolters Kluwer Health)

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