title: Spontaneous retroperitoneal hematoma in a patient under anticoagulant agents presenting as upper gastrointestinal bleeding.
abstract: We present the case of a 44-year-old woman with past history of repeated miscarriage and Budd-Chiari syndrome secondary to primary myelofibrosis. Because of this she was under treatment with oral anticoagulant agents. The patient was admitted in hospital as she presented with gastrointestinal bleeding (melena), asthenia and progressive anemia. In an initial upper endoscopy an extrinsic duodenal compression associated with an ulcer on the posterior face of the first portion of duodenum and upper duodenal knee was observed. In the following days a huge spontaneous retroperitoneal hematoma due to anticoagulation was diagnosed by computed tomography. This was treated with a percutaneous drainage and withdrawal of the antithrombotic drugs. The evolution of the patient was initially satisfactory but she suffered subclavian and jugular vein thrombosis, and reintroduction of anticoagulant agents at the lowest therapeutic doses was required.
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia, España.
authors: Gabriel
authors: G
authors: Carrilero Zaragoza
authors: Unidad de Gestión Clínica de Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia, España.
authors: Juan
authors: J
authors: Egea Valenzuela
authors: Hematología, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: María
authors: M
authors: Moya Arnao
authors: Digestivo/Endoscopias, Hospital Universitario Virgen de la Arrixaca. Murcia, España.
authors: María
authors: M
authors: Muñoz Tornero
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Roxanna
authors: R
authors: Jijón Crespín
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Paula
authors: P
authors: Tomas Pujante
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Elena
authors: E
authors: Iglesias Jorquera
authors: Anatomía Patológica, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Josefa
authors: J
authors: Parra García
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Eduardo
authors: E
authors: Sánchez Velasco
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Ana
authors: A
authors: Pereñíguez López
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Manuel
authors: M
authors: Miras López
authors: Radiodiagnostico, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Matilde
authors: M
authors: Fuster Quiñonero
authors: Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca. Murcia.
authors: Fernando
authors: F
authors: Carballo Álvarez
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D006502:Budd-Chiari Syndrome / Q000188:drug therapy; D004386:Duodenum / Q000473:pathology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging*; 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