title: Enoxaparin-associated giant retroperitoneal hematoma in pulmonary embolism treatment.
abstract: BACKGROUND
  Retroperitoneal hematoma may usually occur as a result of trauma. A life threatening retroperitoneal hematoma is not expected complication of anticoagulation treatment and rarely reported. Low molecular weight heparins (Enoxaparin) which are used as effective and safe medicine in the venous thromboemboly treatment have some major complications such as hematomas of different organs. We aim to present a giant spontaneous retroperitoneal hematoma after anticoagulant treatment of pulmonary embolism with enoxaparin.
  
  
  METHODS
  A 73-year-old male patient with the diagnosis of pulmonary embolism underwent anticoagulant treatment (enoxaparin). In the second day of admission, the patient had an episode of abdominal and back pain. Abdominal ultrasonography and computerized tomographic scan revealed a giant retroperitoneal hematoma. Enoxaparin treatment was then stopped and the supportive treatment was started. In the following days, hemoglobin levels returned to normal and a control CT revealed regression of hematoma size.
  
  
  CONCLUSIONS
  The anticoagulant treatment with enoxaparin may lead to severe hematomas. Therefore, the clinical suspicion is required especially in elderly patients and patients with impaired renal function for retroperitoneal hematoma, when they suffer from acute abdominal pain.
authors.affiliation: Department of Radiology, School of Medicine, Duzce University, Turkey.
authors.forename: Fahri Halit
authors.initials: FH
authors.lastname: Besir
authors.forename: Mesut
authors.initials: M
authors.lastname: Gul
authors.forename: Tacettin
authors.initials: T
authors.lastname: Ornek
authors.forename: Tulay
authors.initials: T
authors.lastname: Ozer
authors.forename: Bulent
authors.initials: B
authors.lastname: Ucan
authors.forename: Levent
authors.initials: L
authors.lastname: Kart