Hematoma of Rectus Sheath Following Subcutaneous Enoxaparin Injection

  • Shahram Firoozbakhsh Division of Pulmonary and Intensive Care Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Reza Parsaei Department of General Surgery, Tehran University of Medical Sciences, Tehran, Iran.
  • Reyhaneh Jafarshad Division of Pulmonary and Intensive Care Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Complications, Enoxaparin, Hematoma, Management, Rectus sheath

Abstract

Anticoagulation drugs are frequently used to prevent deep vein thrombosis in high-risk patients. Subcutaneous low molecular weight heparin (LMWH) is increasingly used in both hospitalized patients and outpatient settings. This necessitates familiarity of both health care providers and patients with such treatment and vigilance on possible complications. Here we present a case of hematoma of rectus sheath that occurred following subcutaneous injection of enoxaparin and was successfully treated with conservative management.

References

Cherry WB, Mueller PS. Rectus sheath hematoma. Review of 126 cases at a single institution. Medicine 2006;85(2):105-10.

Fitzgerald JE, Fitzgerald LA, Anderson FE, Acheson AG. The changing nature of rectus sheath hematoma: case series and literature review. Int J Surg 2009;7(2):150-4.

Kayrak M, Bacaksiz A, Yazici M. Is enoxaparin injection from abdominal wall safe in elderly people?: a fatal case of rectus sheath hematoma. Can Fam Physician 2008;54(9):1246-8.

Sun PL, Lee YC, Chiu KC. Retroperitoneal hemorrhage caused by enoxaparin-induced spontaneous lumbar artery bleeding and treated by transcatheter arterial embolization: a case report. Cases J 2009;2:9375.

Lissoway J, Booth A. Fatal retroperitoneal hematoma after enoxaparin administration in a patient with paroxysmal atrial flutter. Am J Health Syst Pharm 2010;67(10):806-9.

Linhares MM, Lopes Filho GJ, Bruna PC, Ricca AB, Sato NY, Sacalabrini M: Spontaneous hematoma of the rectus abdominis sheath: a review of 177 cases with report of 7personal cases. Int J Surg 1999;84(3):251-7.

All VM, Karnam SM, Kaushik M, Porter J. Spontaneous rectus sheath hematoma. West J Emerg Med.2010;11:76-9.

Salemis NS, Gourgiotis S, Karalis G.Diagnostic evaluation and management of patients with rectus sheath hematoma: A retrospective study. Int J Surg 2010;8(4):290-3.

Costello J, Wright J. Rectus sheath hematoma: a diagnostic dilemma? .Emerg Med J 2005;22:523-34.

Klingler PJ, Wetscher G, Glaser K, Tschmelitsch J, Schmid T, Hinder RA.Use of ultrasound to differentiate rectus sheayh hematoma from other acute abdominal disorders. Surg Endosc 1999;13(11):1129-34.

Moreno Galleo A, Aguayo JL, Flores B, Soria T, Hernández Q, Ortiz S, González-Costea R, Parrilla

P.Ultrasonography and computed tomography reduces unnecessary surgery in abdominal rectus sheath hematoma. Br J Surg 1997;84(4):1295-7.

Berna JD, Garcia-medina V, Guirao J, Garcia medina J. Rectus sheath hematoma: Diagnostic classification by CT. Abdom Imaging 1996;21(1):62-4.

Osinbowale O, Bartholomew JR. Rectus sheath hematoma .Vasc Med 2008;13(4):275-9.

Crooke B, Callaway LK. Fatal haemorrhage associated with enoxaparin. Intern Med J 2007;37(3):207-8.

Mantelas M, Katsiki N, Antonitsis P, Kyurdzhieva E, Mikhailidis DP, Hatzitolios A. Rectus Sheath Hematoma: A Simplified Emergency Surgical Approach. Open Cardiovasc Med J 2011;5:4-5.

Rimola J, Perendreu J, Falcó J, Fortuño JR, Massuet A, Branera J. Percutaneous arterial embolization in the management of rectus sheath hematoma. AJR Am J Roentgenol 2007;188(6):497-502.

How to Cite
1.
Firoozbakhsh S, Parsaei R, Jafarshad R. Hematoma of Rectus Sheath Following Subcutaneous Enoxaparin Injection. Acta Med Iran. 51(5):334-336.
Section
Articles