Rectus Sheath Hematoma: An Unfortunate Consequence of Novel Anticoagulants

Stillman, Kimberly Diane; Kellar, Jesse

doi:10.5811/westjem.2015.2.25631

Cited by 5 publications

(7 citation statements)

References 5 publications

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“…Management of rectus sheath hematoma depends on factors such as the severity and size of the hematoma, the hemodynamic status of the patient, and the extent of anticoagulation. 11 Less severe rectus sheath hematoma is usually self-limiting and can be managed with conservative treatment such as rest, analgesia, ice, and compression. For patients who are hemodynamically unstable, fluid resuscitation or blood transfusion and reversal of anticoagulation may be warranted.…”

Section: Discussionmentioning

confidence: 99%

Rectus Sheath Hematoma Associated with Apixaban

Gunasekaran

Winans

Murthi

et al. 2017

Clinics and Practice

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Apixaban is an oral anticoagulant that directly inhibits Factor Xa and is indicated for the prophylaxis and treatment of deep venous thrombosis and stroke prevention in non-valvular atrial fibrillation. Rectus sheath hematoma is a rare, life-threatening complication of anticoagulant treatment. We describe a case of an elderly patient on apixaban for the treatment of deep venous thrombosis who developed severe abdominal pain during hospitalization. Computed tomography of the abdomen revealed left rectus sheath hematoma. Apixaban was discontinued and the patient was monitored for extension of the hematoma. After 2 days she was discharged home. Outpatient computed tomography 1 month later showed complete resolution of the rectus sheath hematoma. We recommend that clinicians become aware of the potential for rare and serious bleeding complications of anticoagulants and identify the need for early recognition and prompt management.

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Section: Discussionmentioning

confidence: 99%

Rectus Sheath Hematoma Associated with Apixaban

Gunasekaran

Winans

Murthi

et al. 2017

Clinics and Practice

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“…Spontaneous inferior epigastric artery hemorrhage (SIEAH) is a rare condition and can lead to rectus sheath hematoma (RSH), and may thus prove potentially fatal condition (1)(2)(3)(4)(5). Bleeding can lead to hematoma and tamponade; therefore, this episode may be self-limited (2,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…However, in some cases, hemorrhaging can result in hypovolemic shock or even death. Anticoagulant therapy has been reported to be a risk factor of mortality (1,3,4). Other risk factors of SIEAH include hypertension, pregnancy, atherosclerosis, obesity, the use of corticosteroids, thrombophilia and leukemia (1,5,8).…”

Section: Introductionmentioning

confidence: 99%

“…Other risk factors of SIEAH include hypertension, pregnancy, atherosclerosis, obesity, the use of corticosteroids, thrombophilia and leukemia (1,5,8). Initially, conservative treatment, including blood transfusion, anticoagulation therapy and coagulation parameter correction, is the most commonly used treatment (1,2,4,9,10). However, in some patients with an unstable hemodynamic status, invasive intervention is indicated (2,4,9,10).…”

Section: Introductionmentioning

confidence: 99%

“…Initially, conservative treatment, including blood transfusion, anticoagulation therapy and coagulation parameter correction, is the most commonly used treatment (1,2,4,9,10). However, in some patients with an unstable hemodynamic status, invasive intervention is indicated (2,4,9,10). In some selected cases, compared with open surgery, transcatheter arterial embolization (TAE) can be a relatively safe and effective modality for the termination of bleeding (2,9,10).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transcatheter arterial embolization as an effective treatment for spontaneous inferior epigastric artery bleeding caused by anticoagulant therapy: Case reports

et al. 2020

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Spontaneous inferior epigastric artery hemorrhage (SIEAH) is a rare, yet potentially fatal condition. In some cases, the failure of hemostasis can result in hypovolemic shock or even death. Anticoagulant therapy is strongly associated with patient mortality. The present study describes two cases of SIEAH that were successfully dealt with using transcatheter arterial embolization (TAE). The standard use of anticoagulant or antiplatelet agents may induce episodes of severe bleeding, such as SIEAH. Although the condition is rare, it can potentially be life-threatening. The diagnosis mainly depends on computed tomography (CT) findings. With hemodynamic instability, surgical intervention is the most standard treatment. However, in patients with severe comorbidities, old age, or other associated injuries, several post-operative complications may occur. To date, data supporting that TAE is more suitable than the traditional open surgery are lacking. In some selected patients, compared with open surgery, TAE can be a relatively safe and effective modality for the termination of bleeding.

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Aspirin/prasugrel

2015

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Rectus Sheath Hematoma: An Unfortunate Consequence of Novel Anticoagulants

Cited by 5 publications

References 5 publications

Rectus Sheath Hematoma Associated with Apixaban

Rectus Sheath Hematoma Associated with Apixaban

Transcatheter arterial embolization as an effective treatment for spontaneous inferior epigastric artery bleeding caused by anticoagulant therapy: Case reports

Aspirin/prasugrel

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