Extensive spontaneous retroperitoneal hemorrhage: An unusual complication of heparin anticoagulation during pregnancy

Sherer, David M.; Dayal, Ashlesha K.; Schwartz, Benjamin; Oren, Ran; Abulafia, Ovadia

doi:10.1002/(sici)1520-6661(199907/08)8:4<196::aid-mfm12>3.0.co;2-y

Cited by 18 publications

(6 citation statements)

References 15 publications

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“…Iliopsoas haemorrhage in patients with haemophilia is a well‐known complication, and treatises have been published describing this entity [3–5]. Spontaneous iliopsoas and retroperitoneal bleed have also been observed in patients without inherited bleeding disorders, who have been treated with anticoagulants [6–8]. CT scan or ultrasonography is considered to be the preferred methods of confirming the diagnosis [9,10].…”

Section: Discussionmentioning

confidence: 99%

Iliopsoas haemorrhage in patients with bleeding disorders – experience from one centre

et al. 2003

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Iliopsoas haemorrhage in patients with bleeding disorders is a potentially life-threatening condition, with significantly associated morbidity. Despite its clinical importance, little has been published on the frequency, complications or outcomes of this entity since the advent of modern therapies for haemophilia. In a retrospective review of 297 patients with bleeding disorders followed at our centre, we identified 46 episodes of iliopsoas haemorrhage in 31 patients. Patients presented primarily with thigh, hip and/or groin pain, and frequently had flexion hip contracture, femoral nerve paresthesia, and >2 g dL(-1) haemoglobin drop. The duration of symptoms prior to seeking medical attention was 3.8 +/- 4 days. Nineteen of 155 patients (12.3%) with haemophilia A had 28 episodes of iliopsoas bleed; 52.6% of these patients had severe haemophilia. Of these 19 patients with haemophilia A who had iliopsoas haemorrhage, seven (36.8%) had an inhibitor to factor VIII (FVIII), and accounted for one-half of the bleeding episodes. Nine of 66 patients (13.6%) with haemophilia B had 15 episodes of iliopsoas haemorrhage; 22.2% of these patients had severe haemophilia, including one patient with an inhibitor to FIX who had two iliopsoas bleeds. The mean duration of therapy was 18.7 +/- 11.9 days, and the duration of hospitalization was 12.3 +/- 9.1 days. The length of hospital stay was significantly longer in patients with inhibitors, when compared with patients without inhibitors (19.1 +/- 5.8 days vs. 7.6 +/- 7.8 days; P<0.0001) with higher factor consumption, although the total duration of therapy was not significantly different. Patients with inhibitors were over-represented in the cohort of haemophiliacs with iliopsoas bleed. Patients with inhibitors who had iliopsoas bleeds remained hospitalized longer, although the duration of therapy was the same as patients with no inhibitors. There was a low frequency of recurrent bleed (2.8%).

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Section: Discussionmentioning

confidence: 99%

Iliopsoas haemorrhage in patients with bleeding disorders – experience from one centre

et al. 2003

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“…The mainstay treatment of spontaneous retroperitoneal hemorrhage consists of regimen modification or correction of the anticoagulation state, volume resuscitation and transfusion therapy [7]. Amano et al [8] reported that the surgery should be performed immediately in patient with uncontrollable hypotension due to intractable bleeding.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal hemorrhage caused by enoxaparin-induced spontaneous lumbar artery bleeding and treated by transcatheter arterial embolization: a case report

2009

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Lumbar artery bleeding with retroperitoneal hematoma is an uncommon life-threatening complication secondary to enoxaparin use. We present a case of 73-year-old Chinese woman with acute retroperitoneal hemorrhage one month following hip surgery, due to enoxaparine. Enoxaparin induced hemorrhage caused by spontaneous rupture of lumbar artery was suspected and treated successfully by transcatheter arterial embolization.

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“…The mainstay management currently consists of modification or cessation of anticoagulation therapy according to its clinical requirement, correction of the anticoagulation state, volume resuscitation and hemodynamic stabilization with adequate hematology and transfusion therapy and supportive measures [ 23 ]. Small hematomas with mild symptoms of neuropathy, without resultant obscuration, displacement or compression of normal retroperitoneal structures, without the need for multiple transfusions and without signs of infection may be treated conservatively.…”

Section: Discussionmentioning

confidence: 99%

Gigantic retroperitoneal hematoma as a complication of anticoagulation therapy with heparin in therapeutic doses: a case report

et al. 2008

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Introduction: Spontaneous retroperitoneal hemorrhage is a distinct clinical entity that can present as a rare life-threatening event characterized by sudden onset of bleeding into the retroperitoneal space, occurring in association with bleeding disorders, intratumoral bleeding, or ruptures of any retroperitoneal organ or aneurysm. The spontaneous form is the most infrequent retroperitoneal hemorrhage, causing significant morbidity and representing a diagnostic challenge.

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Extensive spontaneous retroperitoneal hemorrhage: An unusual complication of heparin anticoagulation during pregnancy

Cited by 18 publications

References 15 publications

Iliopsoas haemorrhage in patients with bleeding disorders – experience from one centre

Iliopsoas haemorrhage in patients with bleeding disorders – experience from one centre

Retroperitoneal hemorrhage caused by enoxaparin-induced spontaneous lumbar artery bleeding and treated by transcatheter arterial embolization: a case report

Gigantic retroperitoneal hematoma as a complication of anticoagulation therapy with heparin in therapeutic doses: a case report

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