DOI: 10.36347/sjmcr.2018.v06i02.013

Pages: 108-110

A 51-year-old male experienced left lower abdominal pain while running. He was transferred to a local acute critical care center. On arrival, he was in a state of shock. He had also multiple café au lait macules and subcutaneous nodules, suggesting neurofibromatosis-1 (NF1). His shock state was improved by the infusion of lactate ringer solution. Truncal body enhanced computed tomography (CT) revealed retropertoineal hematoma with a sacral body tumor and enriched, enlarged tumor-nourishing blood vessels without extravasation of contrast medium. As his vital signs were stable and there was no sign of active bleeding, conservative therapy was selected. After 10 days, his condition remained unchanged without transfusion, and the volume of the retroperitoneal hematoma had decreased, so he was temporarily discharged and referred to a special tumor orthopedist to evaluate the sacral tumor. As patients with NF1 are occasionally complicated with lethal hemorrhaging in the head, neck, chest and abdomen, including the retroperitoneal space, patients with unstable circulation should be evaluated by whole-body CT to detect the bleeding source in addition to the distribution of asymptomatic tumors.