Multiple Surgical Treatments for Recurrent Retroperitoneal Hemorrhage in a COVID-19 Patient with Respiratory Failure on Extracorporeal Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) may be required in patients with corona virus disease-19 (COVID-19) and respiratory failure. Anticoagulation is the standard treatment to prevent complications of ECMO COVID-19 coagulopathy, however, there a risk bleeding. Some retroperitoneal hemorrhage (RPH) have been treated angiography-embolization. We report on patient who underwent multiple operations (×5) for recurrent RPH. A 46-year-old man was admitted pneumonia. anticoagulation therapy initiated. The developed RPH, caused by external compression inferior vena cava interrupting inflow, surgical hematoma evacuation performed, no obvious bleeding focus during surgeries. Following patient’s recovery, follow-up computed tomography scan showed had resolved, but dilemma regarding anticoagulation. Lowering threshold treatment, enabled serious