title: Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome.
abstract: Spontaneous retroperitoneal hematoma (SRH) is a severe and potentially fatal complication of anticoagulation therapy. We describe a case of fatal spontaneous massive retroperitoneal hematoma in a female patient receiving bridging therapy with enoxaparin for atrial fibrillation. Physicians should be cautious when prescribing enoxaparin in elderly patients, in patients with impaired renal function, and in patients receiving concomitant oral anticoagulants. Emergency physicians should always consider SRH in the differential diagnosis in patients under enoxaparin therapy presenting with abdominal pain. Computed tomographic scan is the imaging modality of choice for evaluating SRH. Early diagnosis and aggressive treatment are of paramount importance as SRH is associated with high mortality and morbidity rates.
authors: Second Department of Surgery, 401 Army General Hospital, Athens, Greece. Electronic address: nikos_salemis@hotmail.com.
authors: Nikolaos S
authors: NS
authors: Salemis
authors: Second Department of Surgery, 401 Army General Hospital, Athens, Greece.
authors: Ioannis
authors: I
authors: Oikonomakis
authors: Second Department of Surgery, 401 Army General Hospital, Athens, Greece.
authors: Emanuel
authors: E
authors: Lagoudianakis
authors: Second Department of Surgery, 401 Army General Hospital, Athens, Greece.
authors: Georgios
authors: G
authors: Boubousis
authors: ICU, 401 Army General Hospital, Athens, Greece.
authors: Christos
authors: C
authors: Tsakalakis
authors: ICU, 401 Army General Hospital, Athens, Greece.
authors: Sotirios
authors: S
authors: Sourlas
authors: First Department of Surgery, 417 NIMTS Veterans' Fund Hospital, Athens, Greece.
authors: Stavros
authors: S
authors: Gourgiotis
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D017984:Enoxaparin / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006406:Hematoma / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin