Delayed renal and liver laceration in patient with low velocity fall in setting of anticoagulation and renal mass: A case report

In this case report, we present a patient with a low velocity fall resulting in thoracoabdominal blunt trauma made occult by the absence of reported history or external physical signs and symptoms. Delayed grade 3 renal laceration and concomitant grade 2 hepatic laceration was the result in this patient that was being treated for septicemia in the setting of urinary tract infection, aspiration pneumonia, and anticoagulation for new-onset atrial fibrillation. This mismatch in initial presentation and severity of the delayed hemorrhagic process of multiple visceral organs after low-velocity blunt injury appears to be rare or significantly underreported. The acute decompensation and insidious course seen in this case highlights the importance of considering a more global assessment of hemorrhagic risk factors, rather than history, hematuria, and initial hemodynamic parameters alone.