Annals of Hematology

, Volume 83, Issue 1, pp 67–70

Successful treatment by selective arterial embolization of severe retroperitoneal hemorrhage secondary to bone marrow biopsy in post-polycythemic myelofibrosis

  • E. Arellano-Rodrigo
  • M. I. Real
  • A. Muntañola
  • M. Burrel
  • M. Rozman
  • G. V. Fraire
  • F. Cervantes
Case Report

DOI: 10.1007/s00277-003-0683-4

Cite this article as:
Arellano-Rodrigo, E., Real, M.I., Muntañola, A. et al. Ann Hematol (2004) 83: 67. doi:10.1007/s00277-003-0683-4

Abstract

Severe retroperitoneal hemorrhage represents an infrequent and serious complication of bone marrow biopsy. A 53-year-old man, diagnosed with polycythemia vera 12 years earlier, was submitted to a bone marrow biopsy due to the appearance of anemia with clinical and hematological features suggesting myelofibrotic transformation, a diagnosis that was confirmed by the marrow study. At 2 h of a right anterior iliac bone marrow trephine biopsy, the patient suddenly developed severe pain in the area of the biopsy, with antialgic flexion of the right leg. Computed tomographic (CT) scan of the abdomen showed a 5×9.5 cm hematoma in the right iliac and psoas muscles. The patient was initially managed with analgesics and transfusional support, but the pain persisted and a continuous fall in the hematocrit was observed in the following days. Angiographic examination of the right external iliac artery showed contrast extravasation arising from the circumflex iliac branch, which was embolized using polivinyl alcohol particles and one coil. Following such procedure, the patient recovered uneventfully and was discharged in good condition a few days later. This case illustrates the effectiveness of an endovascular approach in providing a fast and minimally invasive treatment for this life-threatening complication of bone marrow trephine biopsy.

Keywords

Bone marrow trephine biopsyPolycythemia veraMyelofibrosisRetroperitoneal hemorrhageSelective arterial embolization

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • E. Arellano-Rodrigo
    • 1
  • M. I. Real
    • 2
  • A. Muntañola
    • 1
  • M. Burrel
    • 2
  • M. Rozman
    • 1
  • G. V. Fraire
    • 2
  • F. Cervantes
    • 1
  1. 1.Hematology Department, Institute of Hematology and OncologyPostgraduate School of Hematology Farreras-Valentí, IDIBAPS, Hospital ClínicBarcelona Spain
  2. 2.Vascular and Interventional Radiology Unit, Radiology DepartmentIDIBAPS, Hospital ClínicBarcelona Spain