Management of retroperitoneal hemorrhage compressing the inferior vena cava in a patient with a renal transplant: A case report

We report a case of a right retroperitoneal hematoma compressing the inferior vena cava (IVC) in a patient with a left pelvic renal transplant. Noncontrast abdominal computed tomography scan diagnosed the cause of the hematoma, which was a ruptured nontraumatic renal cyst hemorrhage from the right native kidney. The patient had been anticoagulated for 5 days to treat pulmonary embolism upon clinical presentation. To minimize the risk of venous renal transplant thrombosis and to resume anticoagulation as fast as possible without the need of a long-term IVC filter, priority in management was to relieve the IVC compression and to stop the hemorrhage by selective embolization of the right native kidney. This case report will review the clinical presentation, the radiological findings and the management of retroperitoneal hematoma compressing the IVC in a patient with renal transplant.