Acta clinica Croatica, Vol. 46 No. 4, 2007.
Ostalo
Retroperitoneal Hematoma Following Enoxaparin Treatment in an Elderly Woman
Björn Dario Franjić
Ivo Lovričević
Drago De Syo
Milan Vukelić
Narcis Hudorović
Mario Ledinsky
Tomislav Krpan
Sažetak
Retroperitoneal hematoma may occur as a result of trauma, but also from rupture of arterial aneurysms (aortic or iliac), surgical complications, tumors and anticoagulation therapy. A life threatening retroperitoneal hemorrhage is an infrequent complication of anticoagulation treatment. Enoxaparin is a low-molecular-weight heparin with several advantages over unfractionated heparin. Nevertheless, enoxaparin use is not without risk and severe retroperitoneal bleeding may occur following its use, with a potentially fatal outcome. The case of a 76-year-old woman hospitalized for acute coronary syndrome who developed a large retroperitoneal hematoma on day 5 of enoxaparin therapy is presented. The use of enoxaparin in the acute coronary syndrome as well as in standard thromboprophylaxis has increased over the past decade, which may lead to an increased occurrence of retroperitoneal bleeding in clinical settings. Therefore, physicians should be extremely observant for symptoms and signs of retroperitoneal hemorrhage, and identification of a group of high-risk patients who require close anticoagulation monitoring is mandatory. The treatment of patients with retroperitoneal hematoma should be provided in the intensive care unit setting. Enoxaparin must be discontinued; protamine may be administered depending on the time elapsed from the last enoxaparin dose; fresh frozen plasma and packed red blood cells should be administered if necessary; and surgical intervention may be required if the patient fails to stabilize.
Ključne riječi
Anticoagulants - adverse effects; Enoxaparin - adverse effects; Hematoma - chemically induced; Retroperitoneal space - surgery
Hrčak ID:
21185
URI
Datum izdavanja:
3.12.2007.
Posjeta: 6.398 *