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How dangerous is hematoma when suffering from chronic kidney disease?

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
I had surgery a few years ago. Laproscopic surgery was to remove a 22 cm cyst believed to have been from my kidney. The pathology report after the surgery stated that the cyst came from the adrenal gland. Two weeks after surgery a CT scan showed a 10 cm mass connected to the adrenal gland smaller than the first but still huge to be inside of me, Another surgery was performed,and the adrenal gland was removed, this time by laparotomy. Come to find out is was a 10 cm hematoma. I had normal kidney function before all of this but outer layers of the kidney was removed and 2yrs later I have CKD stage 2 How XXXXXXX was the hematoma, and could I have gotten by without the second surgery?
Posted Sun, 2 Feb 2014 in Thyroid Problem and Hormonal Problems
Answered by Dr. Sudhir 1 hour later
Brief Answer: Hematoma could have been managed differently. Detailed Answer: Hello, It was possible to avoid second surgery. Hematomas like this can be drained by putting a drainage tube. But the problem might have been identifying it as hematoma , as hematomas can exactly look like mass on CT scans. Were you investigated prior to first surgery? If yes , was scan done prior to surgery? Did it showed the adrenal mass ? How much was time interval between two scans? If time interval between scans was short then a scan showing 10 cms mass within two weeks should have aroused possibility of hematoma and not mass. Hope this helps you understand the issue.Please ask if there are doubts.Regards.
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Follow-up: How dangerous is hematoma when suffering from chronic kidney disease? 31 minutes later
Yes I was investigated prior to the first Surgery. Ultra Sound CT Scan and MRI. All believed to have been on the kidney. CT Scan and MRI prior to the second surgery. It was said it was believed to be a hematoma, but it had a solid unidentifiable component within the mass. Because of the first surgery pathology results, they learned that the mass showed no evidence of being kidney related. Only adrenal tissue was found. Because of this Doctors felt it necessary to remove the adrenal gland also with this second surgery. Also the first 22 cm cyst was unsuccessfully drained. It was drained before the first (laproscopic) surgery and would only decrease in size to 10 cm.
Answered by Dr. Sudhir 9 minutes later
Brief Answer: In that case second surgery looks justified. Detailed Answer: Surgery looks justified particularly as it was reported 'solid unidentifiable component within the mass'. As third person or second opinion my opinion is - Its not possible to differentiate a mass from organised hematoma completely. Hope this helps.Please ask if there are doubts or If I have left back any queries. Regards.
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