Do not assume, confirm if it is important

A 78-year-old Portuguese woman came to the emergency room for pain and difficulty to move her right leg. One month before, a retrocolangiogram had been performed to assess the possible persistence of bile duct stones after cholecystectomy. He did not report fever and was not receiving anticoagulants.

A CT scan showed a retroperitoneal collection compatible with hematoma. The hemoglobin value had dropped in one month from 11.5 g / dl to 10 g / dl at the present time.

What would be the safest clinical reasoning attitude of the patient?

  1. A) Assuming that it is a hematoma
  2. B) Request a resonance of the retroperitoneum
  3. C) Treat with antibiotics
  4. D) puncture of the collection

FINAL DIAGNOSIS: A puncture and drainage of the collection showed the presence of a purulent material, and then the patient started with  antibiotic.