A Rare Case of Hydronephrosis Secondary to an Intra-abdominal Haematoma in a Patient with Marfans Syndrome

Luke Stroman, Harikesh Kane

Abstract

A patient with Marfan’s Syndrome and type B aortic dissection presented to an academic teaching hospital with sudden onset left loin to groin pain and haemodynamic instability. Her INR was raised at 9.3 and haemoglobin had dropped from 126 to 106 g/L. CT abdomen revealed unilateral left hydronephrosis secondary to ureteric compression by an 11.8×7.0×8.6 cm retroperitoneal haematoma originating from the left iliacus. The haematoma was managed conservatively with transfusion of fresh frozen plasma and strict bed rest. A left retrograde uretric JJ stent was placed without complication and she was discharged from hospital eight days after presentation.