title: Submucosal hematoma presenting as small bowel obturator obstruction in a patient on low-molecular-weight heparin.
abstract: Recent studies have shown the efficacy of low-molecular-weight heparin (LMWH) in the treatment of venous thromboembolic disease in children. Compared to unfractionated heparin and coumadin, LMWH has more predictable pharmacokinetics and a reported lower incidence of osteoporosis and heparin-induced thrombocytopenia in children. The overall incidence of severe hemorrhage on LMWH in children is low. To date, there is a single report of a small bowel obstruction in a child secondary to a hematoma while on LMWH. We report the second case of a child, on enoxaparin (Lovenox) therapy, who underwent bowel resection secondary to a completely obstructing small bowel wall hematoma.
authors.affiliation: Department of Pediatric Surgery, Long Island College Hospital, State University of New York-Downstate, Brooklyn, NY 11226, USA. ogorikalu@yahoo.com
authors.forename: Ogori N
authors.initials: ON
authors.lastname: Kalu
authors.forename: Georges
authors.initials: G
authors.lastname: Al-Khoury
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Reck
authors.forename: Francisca
authors.initials: F
authors.lastname: Velcek
mesh_terms: D000714:Anastomosis, Surgical; D002675:Child, Preschool; D017984:Enoxaparin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D006406:Hematoma / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D007421:Intestine, Small; D007813:Laparotomy / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D017984:Enoxaparin; D006495:Heparin, Low-Molecular-Weight