Retroperitoneal Hemorrhage After Transradial Cardiac Catheterization in a Patient With Recent Right Kidney Lithotripsy

BACKGROUND: Retroperitoneal hemorrhage is traditionally associated with femoral access during cardiac catheterization. However, with the increased use of transradial access, the incidence of retroperitoneal hemorrhage has decreased. CASE SUMMARY: A 62-year-old man with chest pain underwent an elective coronary angiography via right radial artery. During recovery, he developed abdominal pain with hypotension and tachycardia. Abdominal contrast-enhanced computed tomography revealed a grade 4 subcapsular hematoma in the right kidney, which was managed conservatively. Further history revealed he had undergone an uneventful right kidney lithotripsy 2 weeks before the elective coronary angiography. DISCUSSION: To our knowledge, this is the first documented case of a retroperitoneal hemorrhage after a transradial cardiac catheterization in a patient with recent history of extracorporeal shock wave lithotripsy for kidney stones. TAKE-HOME MESSAGE: This case underscores the importance of a detailed history, particularly when patients have undergone recent renal procedures, including extracorporeal shock wave lithotripsy, that could predispose them to complications.