ABSTRACT
A gastrointestinal bleeding is reportedly the most frequent bleeding site reported and is attributed to hypergastrinemia, gastroduodenal mucosa changes, the defective haemostasis and the use of ulcerogenic drugs (NSAIDS, steroids) (4). Dialysis-associated amyloid may be another cause of gastrointestinal bleeding in maintenance hemodialysis patients (5). Other bleeding episodes that occur at various times during chroinc hemodialysis and often in the absence of a trauma are subdural hematoma (6) (Fig. 1), haemopericardium (7), haemorrhagic pleural effusion (8) and retroperitoneal hematoma (9) (Fig. 2). Further bleeding sites are: hemorrhage in the anterior chamber of the eye (10), mediastinal haemorrhage (11), subcapsular liver hematoma (12), hemorrhage in a renal cyst or diffuse subcapsular renal bleeding (Fig. 3), ovarian hemorrhage (13), and hemarthros (14). A severe secondary hyperparathyroidism may lead to spontaneous parathyroid hemorrhage with a rapidly enlarging cervical mass (15). Today, modern imaging techniques should be applied early in order to identify the bleeding site and to allow active therapeutic measures (i.e., evacuation of the hematomas).
