title: Hemorrhagic complications of anticoagulant therapy: role of multidetector computed tomography and spectrum of imaging findings from head to toe.
abstract: Highly effective in preventing and treating thromboembolic conditions in acute and chronic settings, anticoagulant therapy is associated with a non-negligible risk of hemorrhagic complications with a considerable clinical impact. Advanced age and comorbidities further increase the risk of bleeding during heparinization, treatment with low-molecular-weight heparins or long-term oral warfarin anticoagulation. Multidetector computed tomography represents the mainstay diagnostic technique to image-suspected hemorrhages in anticoagulated patients, as it can quickly assess presence, site, and extent of hemorrhage, identify active bleeding, and possible underlying diseases. Cross-sectional imaging appearances of the wide spectrum of anticoagulant therapy-related bleeding complications are hereby presented, including peripheral and thoracic-abdominal wall muscular hematomas, intrathoracic, abdominal, retroperitoneal genitourinary, gastrointestinal, and brain hemorrhages. Prompt recognition and comprehensive diagnostic assessment with multidetector computed tomography allow clinicians to correctly choose treatment modification or withdrawal, surgery, or interventional procedures as needed, with the aim to reduce the associated morbidity and mortality.
authors.affiliation: Department of Radiology, Luigi Sacco University Hospital, Milan, Italy. mtonolini@sirm.org
authors.forename: Massimo
authors.initials: M
authors.lastname: Tonolini
authors.forename: Sonia
authors.initials: S
authors.lastname: Ippolito
authors.forename: Francesca
authors.initials: F
authors.lastname: Patella
authors.forename: Marina
authors.initials: M
authors.lastname: Petullà
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D018570:Risk Assessment; D013923:Thromboembolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D000925:Anticoagulants