Spontaneously Resolved Gigantic Retroperitoneal Hematoma Following Oophorectomy: A Case Report in a Cardiac Patient on Anticoagulant Therapy

Retroperitoneal hemorrhage is a clinical entity that can present as a rare life-threatening event, causing significant morbidity and representing a diagnostic challenge. We report the case of a patient with double mitral and aortic valve replacement who presented with retroperitoneal hematoma after right salpingo-ophrectomy, in whom anticoagulant therapy with warfarin and heparin aggravated the retroperitoneal hemorrhage, which was treated conservatively. Delay in diagnosis is potentially fatal and high clinical suspicion remains crucial. Finally, it is a matter of controversy whether retroperitoneal hematomas should be surgically evacuated or conservatively treated and the final decision should be made after taking into consideration the patient's general condition and the possibility of permanent femoral or sciatic neuropathy due to compression syndrome.