scholarly journals Rectus sheath hematoma in patients receiving subcutaneous enoxaparin: A case series of five patients

2020 ◽  
Vol 8 (12) ◽  
pp. 3432-3439
Author(s):  
Diogo Mendes ◽  
Ana Penedones ◽  
Michele Martins ◽  
Susana Cavadas ◽  
Carlos Alves ◽  
...  
Keyword(s):  
Case Series ◽  
Rectus Sheath ◽  
Subcutaneous Enoxaparin ◽  
Rectus Sheath Hematoma

Prophylactic unfractionated heparin and hemorrhage in neurocritically ill underweight patients: A case series and review of the literature

2020 ◽  
Vol 77 (19) ◽  
pp. 1571-1577
Author(s):  
Sean M McConachie ◽  
Amy Morin ◽  
Karim Mouabbi ◽  
Ayman O Soubani ◽  
Krista Wahby
Keyword(s):  
Unfractionated Heparin ◽  
Subdural Hematoma ◽  
Obstructive Hydrocephalus ◽  
Case Series ◽  
Stable Condition ◽  
Rectus Sheath ◽  
Chronic Subdural Hematoma ◽  
Underweight Patients ◽  
Medical Histories ◽  
Rectus Sheath Hematoma

Abstract Purpose Three cases of major bleeding associated with thromboprophylactic unfractionated heparin (UFH) therapy in underweight neurocritically ill patients are reported. Summary Three underweight patients (body mass index of <18.5 kg/m2) were treated in the intensive care unit with major bleeds associated with UFH thromboprophylaxis. Two of the patients, a 76-year-old female and a 56-year-old female, had hemorrhages on presentation; the third patient, a 29-year-old male, developed bleeding during his admission. All 3 patients had past medical histories consisting of acute neurologic conditions within 6 weeks of presentation, including subdural hematoma, subarachnoid hemorrhage, and obstructive hydrocephalus secondary to a brain mass. All hemorrhages developed following the receipt of prophylactic UFH at doses of 5,000 units every 8 to 12 hours, which translated to high weight-based dosages (>300 units/kg/d). Additionally, hemorrhages were associated with prolonged activated partial thromboplastin time, which declined following heparin discontinuation. The major bleeds following UFH administration included an acute on chronic subdural hematoma, acute rectus sheath hematoma, and cerebellar hematoma. Stabilization of the subdural hematoma was achieved without the use of protamine and the patient was discharged in stable condition. The other 2 patients expired secondary to their hemorrhagic events. Naranjo nomogram scores for the patients indicated that heparin was the probable cause of bleed in 2 cases and a possible cause in 1 case. Conclusion Three major hemorrhages developed following the administration of UFH. Underweight patients with neurologic injury may require increased clinical vigilance, reduced doses, and pharmacodynamic monitoring to improve safety outcomes associated with thromboprophylaxis.

scholarly journals A Case Series of Life-Threatening Hemorrhagic Events in Patients with COVID-19

2021 ◽  
Author(s):  
Abbas Hajian
Keyword(s):  
Bleeding Complication ◽  
Medical Center ◽  
Case Series ◽  
Rectus Sheath ◽  
Surgical Care ◽  
Pulmonary Involvement ◽  
Autopsy Study ◽  
Hemorrhagic Events ◽  
Life Threatening ◽  
Rectus Sheath Hematoma

AbstractSince venous microthrombotic and thromboembolic events in end organs have been pathophysiologically confirmed as a component of thrombo-inflammatory cascade in COVID-19 syndrome, anticoagulant prescription with prophylactic or therapeutic goal is recommended. Different guidelines for the above are introduced; however, there is no general consensus on any neither the type of anticoagulant nor for the dosage and duration of prescription. In our medical center, adopted internal guideline was considered for patients COVID-19. We consulted patients with COVID-19 who suffered from concurrent hematoma. Appropriate surgical approach was considered. Finally autopsy study was performed for patients. In this article, we presented a series of seven SARS-CoV-2 confirmed cases faced with bleeding complication following initiation of anticoagulation protocol. The rectus sheath hematoma with extension to pelvic and/or retroperitoneal space, even involving bowel mesentery was seen most commonly. Despite receiving appropriate surgical care, all seven cases died. Finally, in all cases, autopsy studies revealed no evidence for confirmation of DIC/SIC or organ failure as the reason of death although pulmonary involvement with SARS-CoV-2 and bleeding phenomena were approved. The nature of the COVID-19 syndrome makes patients vulnerable to hemorrhagic events following anticoagulant administration which relatively causes or accelerates patient’s expiration.

Spontaneous Rectus Sheath Hematoma During Pregnancy Mimicking Abruptio Placenta

1997 ◽  
Vol 14 (06) ◽  
pp. 321-323 ◽  
Author(s):  
Mildred Ramirez ◽  
James Burkhead ◽  
Mark Turrentine
Keyword(s):  
Rectus Sheath ◽  
Abruptio Placenta ◽  
Rectus Sheath Hematoma
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