Retroperitoneal hemorrhage associated with bone marrow trephine biopsy

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Diagnostic/therapeutic accidents Background: Bone marrow (BM) trephine biopsy is generally a safe procedure, but adverse events such as retroperitoneal hemorrhage (RPH) may occur. We report 3 cases of this complication. Case Report: A 19-year-old male with thrombocytopenia and coagulopathy underwent BM trephine biopsy to confirm relapse of acute lymphoblastic leukemia. Two hours later, he developed severe hypotension and a CT scan revealed a massive RPH, and was treated conservatively. The RPH recurred 2 weeks after chemotherapy and was successfully treated with gel foam embolization. A 55-year-old male with coagulopathy underwent BM trephine biopsy for hyperleukocytosis and thrombocytosis. He developed a large RPH preceded by left lumbar dermatome sensory neuropathy. He was treated conservatively. A 56-year-old overweight woman on aspirin underwent BM trephine biopsy for polycythemia. Twelve hours later she developed severe abdominal pain with hypotension. A CT scan showed a massive RPH and secondary hemothorax. She was treated conservatively and the RPH resolved after several months. Conclusions: We and others showed that myeloproliferative neoplasm, quantitative or qualitative platelet abnormalities, aspirin, coagulopathy, and obesity are associated with development of RPH following BM trephine biopsy. Early diagnosis and intervention are crucial. Correction of coagulopathy and cessation of anti-platelet treatment prior to biopsy can prevent this serious complication.

Original languageEnglish
Pages (from-to)489-493
Number of pages5
JournalAmerican Journal of Case Reports
Volume14
DOIs
Publication statusPublished - 20 Nov 2013

Fingerprint

Bone Marrow
Hemorrhage
Biopsy
Hypotension
Aspirin
Blood Platelets
Hemothorax
Thrombocytosis
Polycythemia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Thrombocytopenia
Abdominal Pain
Accidents
Early Diagnosis
Obesity
Gels
Recurrence
Drug Therapy
Therapeutics
Neoplasms

Keywords

  • Bone marrow trephine biopsy
  • Retroperitoneal hematoma
  • Retroperitoneal hemorrhage

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Retroperitoneal hemorrhage associated with bone marrow trephine biopsy. / Wan Jamaludin, Wan Fariza; Mohamed Mukari, Shahizon Azura; S. Abdul Wahid, S Fadilah.

In: American Journal of Case Reports, Vol. 14, 20.11.2013, p. 489-493.

Research output: Contribution to journalArticle

@article{e794a273296344df94fce082b9e7d74f,
title = "Retroperitoneal hemorrhage associated with bone marrow trephine biopsy",
abstract = "Objective: Diagnostic/therapeutic accidents Background: Bone marrow (BM) trephine biopsy is generally a safe procedure, but adverse events such as retroperitoneal hemorrhage (RPH) may occur. We report 3 cases of this complication. Case Report: A 19-year-old male with thrombocytopenia and coagulopathy underwent BM trephine biopsy to confirm relapse of acute lymphoblastic leukemia. Two hours later, he developed severe hypotension and a CT scan revealed a massive RPH, and was treated conservatively. The RPH recurred 2 weeks after chemotherapy and was successfully treated with gel foam embolization. A 55-year-old male with coagulopathy underwent BM trephine biopsy for hyperleukocytosis and thrombocytosis. He developed a large RPH preceded by left lumbar dermatome sensory neuropathy. He was treated conservatively. A 56-year-old overweight woman on aspirin underwent BM trephine biopsy for polycythemia. Twelve hours later she developed severe abdominal pain with hypotension. A CT scan showed a massive RPH and secondary hemothorax. She was treated conservatively and the RPH resolved after several months. Conclusions: We and others showed that myeloproliferative neoplasm, quantitative or qualitative platelet abnormalities, aspirin, coagulopathy, and obesity are associated with development of RPH following BM trephine biopsy. Early diagnosis and intervention are crucial. Correction of coagulopathy and cessation of anti-platelet treatment prior to biopsy can prevent this serious complication.",
keywords = "Bone marrow trephine biopsy, Retroperitoneal hematoma, Retroperitoneal hemorrhage",
author = "{Wan Jamaludin}, {Wan Fariza} and {Mohamed Mukari}, {Shahizon Azura} and {S. Abdul Wahid}, {S Fadilah}",
year = "2013",
month = "11",
day = "20",
doi = "10.12659/AJCR.889274",
language = "English",
volume = "14",
pages = "489--493",
journal = "American Journal of Case Reports",
issn = "1941-5923",
publisher = "International Scientific Literature, Inc",

}

TY - JOUR

T1 - Retroperitoneal hemorrhage associated with bone marrow trephine biopsy

AU - Wan Jamaludin, Wan Fariza

AU - Mohamed Mukari, Shahizon Azura

AU - S. Abdul Wahid, S Fadilah

PY - 2013/11/20

Y1 - 2013/11/20

N2 - Objective: Diagnostic/therapeutic accidents Background: Bone marrow (BM) trephine biopsy is generally a safe procedure, but adverse events such as retroperitoneal hemorrhage (RPH) may occur. We report 3 cases of this complication. Case Report: A 19-year-old male with thrombocytopenia and coagulopathy underwent BM trephine biopsy to confirm relapse of acute lymphoblastic leukemia. Two hours later, he developed severe hypotension and a CT scan revealed a massive RPH, and was treated conservatively. The RPH recurred 2 weeks after chemotherapy and was successfully treated with gel foam embolization. A 55-year-old male with coagulopathy underwent BM trephine biopsy for hyperleukocytosis and thrombocytosis. He developed a large RPH preceded by left lumbar dermatome sensory neuropathy. He was treated conservatively. A 56-year-old overweight woman on aspirin underwent BM trephine biopsy for polycythemia. Twelve hours later she developed severe abdominal pain with hypotension. A CT scan showed a massive RPH and secondary hemothorax. She was treated conservatively and the RPH resolved after several months. Conclusions: We and others showed that myeloproliferative neoplasm, quantitative or qualitative platelet abnormalities, aspirin, coagulopathy, and obesity are associated with development of RPH following BM trephine biopsy. Early diagnosis and intervention are crucial. Correction of coagulopathy and cessation of anti-platelet treatment prior to biopsy can prevent this serious complication.

AB - Objective: Diagnostic/therapeutic accidents Background: Bone marrow (BM) trephine biopsy is generally a safe procedure, but adverse events such as retroperitoneal hemorrhage (RPH) may occur. We report 3 cases of this complication. Case Report: A 19-year-old male with thrombocytopenia and coagulopathy underwent BM trephine biopsy to confirm relapse of acute lymphoblastic leukemia. Two hours later, he developed severe hypotension and a CT scan revealed a massive RPH, and was treated conservatively. The RPH recurred 2 weeks after chemotherapy and was successfully treated with gel foam embolization. A 55-year-old male with coagulopathy underwent BM trephine biopsy for hyperleukocytosis and thrombocytosis. He developed a large RPH preceded by left lumbar dermatome sensory neuropathy. He was treated conservatively. A 56-year-old overweight woman on aspirin underwent BM trephine biopsy for polycythemia. Twelve hours later she developed severe abdominal pain with hypotension. A CT scan showed a massive RPH and secondary hemothorax. She was treated conservatively and the RPH resolved after several months. Conclusions: We and others showed that myeloproliferative neoplasm, quantitative or qualitative platelet abnormalities, aspirin, coagulopathy, and obesity are associated with development of RPH following BM trephine biopsy. Early diagnosis and intervention are crucial. Correction of coagulopathy and cessation of anti-platelet treatment prior to biopsy can prevent this serious complication.

KW - Bone marrow trephine biopsy

KW - Retroperitoneal hematoma

KW - Retroperitoneal hemorrhage

UR - http://www.scopus.com/inward/record.url?scp=84887878774&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887878774&partnerID=8YFLogxK

U2 - 10.12659/AJCR.889274

DO - 10.12659/AJCR.889274

M3 - Article

AN - SCOPUS:84887878774

VL - 14

SP - 489

EP - 493

JO - American Journal of Case Reports

JF - American Journal of Case Reports

SN - 1941-5923

ER -