Musa EKİCİ, Asım ÖZAYAR, Berat Cem ÖZGÜR, Ömer BAYRAK

Kontrolsüz hipertansiyon ve antikoagülan tedaviye bağlı oluşan spontan renal subkapsüler hematom olgusu

Spontan subkapsüler hematom anatomik kapsüle sahip organlarda çok nadir olarak izlenen bir patolojidir. Böbrek de subkapsüler kanamanın gözlenebileceği anatomik yapılardan birisidir ve hastada klinik olarak hiçbir semptom görülmeyeceği gibi hayatı tehdit edebilen kanama tablosu ile de karşımıza çıkabilir. Tanı aşamasında çok fazla tartışma yaşanmazken tedavi aşamasında farklı görüşler savunulmaktadır. Altta yatan etyolojiye ve hastanın co-morbid durumuna göre tedavi planı çeşitlilik göstermektedir. Konservatif yaklaşım, kapsülotomi, perkütan drenaj ve nefrektomi gibi farklı tedavi planları uygulanabilir. Seksen dört yaşında antikoagülan kullanma öyküsü olan hipertansif atak nedeni ile acil servise başvuran, görüntüleme yöntemleri ile renal subkapsüler hematom tanısı konan kadın hastanın konservatif yaklaşım ile değerlendirilmesi literatür eşliğinde sunulmuştur.

A spontaneous renal subcapsular hematoma case due to uncontrolled hypertension and anticoagulant therapy

Spontaneous subcapsular hematoma is a rare pathology which presents in capsular organs in the body. Kidney is also an anatomic structure where a subcapsular bleeding can be identified, although there might be no clinical sign, a life treating appearance might exist with the patient. In diagnosis, usually no argument occurs, while there is not a consensus in the treatment. Decision of the treatment has variations due to the etiology and patient's clinical situation. Different treatment modalities as conservative approach, capsulotomy, percutaneus drainage and radical nephrectomy might be the options. A 84 year-old female patient who has a history of anticoagulant intake admitted to the emergency department with a hypertensive episode and with imaging methods, renal subcapsular hematoma was diagnosed, conservative approach was commented in the light of the current literature.

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