Dalteparin-associated catastrophic retroperitoneal hematoma successfully treated with recombinant factor VIIa.

Abstract:

:Low-molecular-weight heparins (LMWHs) have been widely used in many clinical settings. LMWH-associated spontaneous retroperitoneal hematoma (SRH) has been reported mostly in patients treated with enoxaparin. We here present a 76-year-old man with renal insufficiency treated with dalteparin for acute myocardial infarction, who developed catastrophic SRH with intra-abdominal hypertension (IAH) and hemothorax. Because of the high risk of surgical intervention, we performed ultrasound-guided abdominal paracentesis and thoracentesis to relieve IAH and respiratory distress. Vigorous supportive care with massive blood product transfusions was given to stabilize his hemodynamics. Finally, the bleeding was stopped with a powerful hemostatic agent, recombinant factor VIIa. Surgical evacuation of a 3,600 mL blood clot was performed successfully 1 month later.

journal_name

Int Urol Nephrol

authors

Wang CH,Chen YC,Tsao CW,Yang SS

doi

10.1007/s11255-011-0104-x

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

1091-5

issue

4

eissn

0301-1623

issn

1573-2584

journal_volume

44

pub_type

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