einstein (São Paulo). 27/Jan/2021;19:eAI5829.

Spontaneous subepithelial hemorrhage: the Antopol-Goldman lesion

Eduardo Kaiser Ururahy Nunes , Roberto Vitor Almeida , Luiz Raphael Pereira Donoso , Cesar Higa

DOI: 10.31744/einstein_journal/2021AI5829

A 55-year-old man admitted to our emergency department complaining of right flank acute pain. He also referred epistaxis, gingival bleeding, and hematuria for the past 3 days. His physical exam demonstrated abdominal subcutaneous hematomas and he referred abdominal tenderness on palpation. Seven days before these symptoms, his daily warfarin dose has been increased. His blood tests showed that the International Normalized Ratio was markedly elevated (3.6; his previous exam from before dosage increase was 2.2).

An abdominal computed tomography was requested () and showed hyperattenuating and non-enhancing circumferential thickening of the right ureter wall, compatible with extensive parietal hematoma.

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Spontaneous subepithelial hemorrhage: the Antopol-Goldman lesion
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