Spontaneous Mediastinal Hemorrhage in a Patient with End Stage Renal Disease: An Unusual Case of Uremic Bleeding

Korean Journal of Nephrology 2011;30(2):196-200.

Sangheun Lee, M.D., In Tae Kim, M.D., Hyung Bok Park, M.D., Yu Kyung Hyun, M.D., Yoon Ji Kim, M.D., Soo Young Yoon, M.D. and Sang Choel Lee, M.D.

Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea

증례 : Spontaneous Mediastinal Hemorrhage in a Patient with End Stage Renal Disease: An Unusual Case of Uremic Bleeding

Sangheun Lee, M.D., In Tae Kim, M.D., Hyung Bok Park, M.D., Yu Kyung Hyun, M.D., Yoon Ji Kim, M.D., Soo Young Yoon, M.D. and Sang Choel Lee, M.D.

Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea

Abstract

Hemorrhagic complications in patients with end stage renal disease (ESRD) are common. These abnormal bleeding tendencies are caused by several factors including anticoagulation during hemodialysis, anemia, and uremic platelet dysfunction. The most common clinical manifestation of uremic bleeding is hemorrhage of the gastrointestinal tract from gastric ulcer disease. Mediastinal bleeding, however, is rare in ESRD patients. Here, we report a case of spontaneous mediastinal bleeding in a patient with hemodialysis. A huge periesophageal hematoma was observed on the chest CT scan and the bleeding time representing platelet function was prolonged. This case underlies the diversity of uremic bleeding.

Key Words: Uremia, Hemorrhage, Mediastinum