title: Massive retroperitoneal hematoma as a complication of anticoagulation therapy in a patient treated in a pulmonary intensive care unit.
abstract: BACKGROUND
  Retroperitoneal hematoma may occur as a result of trauma, but also from rapture of arterial aneurysms (aortic or iliac), surgical complications, tumors or anticoagulation therapy.
  
  
  METHODS
  We presented a patient on permanent anticoagulation therapy. On the day of admission to our institudon, the patient had the value of his INR 5.57 which required immediate suspension of the therapy. The main symptom in this patient was pain in the right inguinal canal with propagation along the right leg, which was indicated in clinical picture of spontaneous retroperitoneal haematoma. After three days the fall of hemoglobin occurred, so the additonal diagnostics was done. A computed tomography of the abdomen was performed showing well limited, large retroperitoneal hematoma (213 x 79 x 91 mm). Transfusion of concentrated red blood cells was performed twice with satisfactory correction of hemoglobin level, and four units of fresh frozen plasma. The patient was hemodynamically stabilized and discharged after a two-month long intensive care unit treatment, with the advice to use low-molecular weight heparin 2 x 0.4 mg subcutaneusly, due to persistent arrhythmia.
  
  
  CONCLUSIONS
  In patients on anticoagulation therapy regular monitoring of the anticoagulant status is extremely important, because of the possibility of fatal complications development, such as retroperitoneal hematoma.
authors.forename: Mihailo
authors.initials: M
authors.lastname: Stjepanović
authors.forename: Ivana
authors.initials: I
authors.lastname: Buha
authors.forename: Snezana
authors.initials: S
authors.lastname: Raljević
authors.forename: Uroš
authors.initials: U
authors.lastname: Babić
authors.forename: Milan
authors.initials: M
authors.lastname: Savić
authors.forename: Jovana
authors.initials: J
authors.lastname: Mašković
authors.forename: Marina
authors.initials: M
authors.lastname: Roksandić
authors.forename: Dragana
authors.initials: D
authors.lastname: Marić
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D006406:Hematoma / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012187:Retroperitoneal Space; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants