Rectus sheath hematoma with low molecular weight heparin administration: a case series

BMC Research Notes

Kayleigh M Litton¹  Dale C Wortham¹  Laura E J Sullivan¹ 

[1] University of Tennessee, Knoxville 1924 Alcoa Highway, Box 56, Knoxville, TN 37920, USA

关键词: Enoxaparin;    Anticoagulation;    Low molecular weight heparin;    Rectus sheath hematoma;   

Others  :  1129998
DOI  :  10.1186/1756-0500-7-586

 received in 2013-12-16, accepted in 2014-08-13,  发布年份 2014

【 摘 要 】

Background

Rectus sheath hematoma is an uncommon but potentially serious bleeding complication that can occur spontaneously or as a result of anticoagulation administration.

Case presentation

Case number one: A 62 year old chronically ill Caucasian female develops a rectus sheath hematoma seven days after hospital discharge. The previous hospitalization included low molecular weight heparin administration for deep vein thrombosis prophylaxis. The patient ultimately chooses comfort care and expires due to sepsis and respiratory failure. Case number two: A 79 year old Caucasian male develops a rectus sheath hematoma during hospital admission where LMWH is used for deep vein thrombosis prophylaxis. He is managed conservatively; however, his hematocrit drops from 46 to 25.8%. Case number three: A 44 year old chronically ill Caucasian female is treated with therapeutic low molecular weight heparin for recent deep vein thrombosis during a hospital admission. She develops a large rectus sheath hematoma requiring embolization as well as blood transfusion.

Conclusion

We believe this reflects an underreported significant cause of morbidity and mortality with low molecular weight heparin administration. We review the pathophysiology of rectus sheath hematoma as well as its presentation, diagnosis, and treatment. We identify at-risk populations and proposed contributing factors. We also discuss factors leading to underreporting as well as preventive strategies implemented at our institution.

【 授权许可】

   
2014 Sullivan et al.; licensee BioMed Central Ltd.

【 图 表 】

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