Inguinal canal and retroperitoneal hematoma during femoral puncture

5:22 PM Posted by Dr Subhash Kumar, MBBS, MD, DM

Hemorrhage during femoral puncture prior to angiography is a rare complication and if unnoticed can lead to fatal retroperitoneal hematoma.
In this case we were able to identify the hemorhage only because the guidewire was not passing up straight and there was a very deceptive free back flow of blood from the sheath. However the arterial lumen was patent and the internal bleeding stopped soon after after removing the sheath and manual compression for 5 min.
Figure showing right inguinal canal and retroperitoneal hematoma. large arrow in fig A shows the constriction at the site of inguinal ligament. Small arrow indicates the femoral sheath. Double small arrow in Fig B shows the femoral catheter passed up the left femoral artery, dotted arrow in Fig B indicates free antegrade flow in right femoral artery. Note that the contrast pool has decreased in Fig B.


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