A spontaneous intramural hematoma of the bowel presenting as obstruction in a child receiving low-molecular-weight heparin.
Low-molecular-weight heparin (LMWH) is a safe and effective alternative to unfractionated heparin and coumadin in the treatment and prophylaxis of thrombosis in children. When compared with these more established anticoagulants, it is easier to achieve therapeutic levels and the incidence of hemorrhagic complications is equivalent or lower. In children there is less published experience than in adults, but the low frequency of significant bleeding appears to be similar. The authors describe a child on therapeutic doses of LMWH for a deep vein thrombosis who spontaneously developed an intramural hemorrhage in his small bowel, leading to infarction and a partial bowel resection.
Shaw
Peter H
PH
Department of Pediatrics, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, Pittsburgh, PA 15213-2583, USA. shawph@chpedu
Ranganathan
Sarangarajan
S
Gaines
Barbara
B
D000925:Anticoagulants / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D006406:Hematoma / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D007415:Intestinal Obstruction / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology*; D008297:Male
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight