Skip to main content Skip to main navigation menu Skip to site footer

Spontaneous retrovesical bleeding on COVID-19 patient: A rare case

  • Faathir Baihaqi Ghifary ,
  • Tanaya Ghinorawa ,


Introduction: COVID-19 does not merely cause respiratory distress as a clinical manifestation but also can develop into other systemic conditions such as cardiovascular, neurologic, hematopoietic, coagulopathy, and immunity disorders, and finally, multiple organ failure. This case aims to report a rare case of spontaneous retrovesical bleeding as one of the complications of COVID-19

Case Description: The patient was a female 66 years old with COVID-19 who complained of abdominal mass, followed by abdominal pain, decrease of consciousness, and unstable hemodynamics. During exploratory laparotomy, we found hematoma and diffuse bleeding from the retrovesical space. During the treatment of COVID-19, the patient was also administered enoxaparin to prevent venous thromboembolism.

Conclusion: Coagulopathies in patients with COVID-19, aggravated with the administration of enoxaparin, induce spontaneous retrovesical bleeding. Moreover, the clinical manifestation of spontaneous retrovesical bleeding was atypical, making it challenging to recognize and diagnose early.



  1. Gupta A, Madhavan M V., Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017–32. doi:10.1038/s41591-020-0968-3
  2. Debora L, Suprapti B, Kusumawati D, Arina Dery PS, Gabriella Nathasya T, Arini MN, et al. Analysis of Enoxaparin Effectiveness Based on COVID-19 Severity: A Study in a Secondary Hospital in Bandung, Indonesia. Indones J Pharm. 2022;33(3):381–93. doi:10.22146/ijp.4133
  3. Harrow BR. Traumatic perivesical hematoma: late sequela of false ileac aneurysm. J Urol. 1970;104(2):271–2. doi:10.1016/S0022-5347(17)61715-4
  4. Eljilany I, Elzouki AN. D-dimer, fibrinogen, and il-6 in covid-19 patients with suspected venous thromboembolism: A narrative review. Vasc Health Risk Manag. 2020;16:455–62. doi:10.2147/VHRM.S280962
  5. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834–47. doi:10.1002/ajh.25829
  6. Asakura H, Ogawa H. COVID-19-associated coagulopathy and disseminated intravascular coagulation. Int J Hematol. 2021 Jan;113(1):45–57. doi:10.1007/s12185-020-03029-y
  7. Sunga KL, Bellolio MF, Gilmore RM, Cabrera D. Spontaneous retroperitoneal hematoma: Etiology, characteristics, management, and outcome. J Emerg Med. 2012;43(2):e157–61. doi:10.1016/j.jemermed.2011.06.006
  8. Simsek A, Ozgor F, Yuksel B, Bastu E, Akbulut MF ati., Kucuktopcu O, et al. Spontaneous retroperitoneal hematoma associated with anticoagulation therapy and antiplatet therapy: two centers experiences. Arch Ital Urol Androl. 2014;86(4):266–9. doi:10.4081/aiua.2014.4.266
  9. Moudouni SM, En-Nia I, Patard JJ, Guille F, Lobel B. Hématomes spontanés de la loge rénale: Diagnostic et traitement. À propos de deux cas. Ann Urol (Paris). 2002;36(1):29–32. doi:10.1016/S0003-4401(01)00065-1
  10. Llitjos JF, Daviaud F, Grimaldi D, Legriel S, Georges JL, Guerot E, et al. Ilio-psoas hematoma in the intensive care unit: A multicentric study. Ann Intensive Care. 2016;6(1):4–9. doi:10.1186/s13613-016-0106-z
  11. Qanadli SD, El Hajjam M, Mignon F, Bruckert F, Chagnon S, Lacombe P. Life-threatening spontaneous psoas haematoma treated by transcatheter arterial embolization. Eur Radiol. 1999;9(6):1231–4. doi:10.1007/s003300050824
  12. Chan YC, Morales JP, Reidy JF, Taylor PR. Management of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery? Int J Clin Pract. 2008;62(10):1604–13. doi:10.1111/j.1742-1241.2007.01494.x
  13. Kipshidze N, Dangas G, White CJ, Kipshidze N, Siddiqui F, Lattimer CR, et al. Viral Coagulopathy in Patients With COVID-19: Treatment and Care. Clin Appl Thromb. 2020;26. doi:10.1177/1076029620936776
  14. Delshad M, Safaroghli-Azar A, Pourbagheri-Sigaroodi A, Poopak B, Shokouhi S, Bashash D. Platelets in the perspective of COVID-19; pathophysiology of thrombocytopenia and its implication as prognostic and therapeutic opportunity. Int Immunopharmacol. 2021 Oct;99:107995. doi:10.1016/j.intimp.2021.107995
  15. Gubernatorova EO, Gorshkova EA, Polinova AI, Drutskaya MS. IL-6: Relevance for immunopathology of SARS-CoV-2. Cytokine Growth Factor Rev. 2020 Jun;53:13–24. doi:10.1016/j.cytogfr.2020.05.009
  16. Reviono, Hendrastutik, Sari Y, Suryawati B, Ismail D, Yasa KP. Frequency of Interleukin-6 rs 1800796 (-572G/C) and 2069837 (intron 2A/G), TNF-α rs1800750 (-376G/A), and 1800629 (-308G/A) polymorphism in COVID-19 patients with clinical degrees in Central Java. Bali Med J. 2022;11(3). doi:10.15562/bmj.v11i3.3552

How to Cite

Ghifary, F. B., & Ghinorawa, T. . (2024). Spontaneous retrovesical bleeding on COVID-19 patient: A rare case. Indonesia Journal of Biomedical Science, 18(1), 37–40.




Search Panel

Faathir Baihaqi Ghifary
Google Scholar
IJBS Journal

Tanaya Ghinorawa
Google Scholar
IJBS Journal