Retroperitoneal Hematoma and Enoxaparin

Letters16 November 1999Retroperitoneal Hematoma and EnoxaparinJean-Paul Montoya, MD, Nagaprasadrao Pokala, MD, and Stephen L. Melde, MDJean-Paul Montoya, MDTexas A&M University Health Science Center College of Medicine; Temple, TX 76508 (Montoya)Central Texas Veterans Healthcare System; Temple, TX 76504 (Pokala)Central Texas Veterans Healthcare System; Temple, TX 76504 (Melde), Nagaprasadrao Pokala, MDTexas A&M University Health Science Center College of Medicine; Temple, TX 76508 (Montoya)Central Texas Veterans Healthcare System; Temple, TX 76504 (Pokala)Central Texas Veterans Healthcare System; Temple, TX 76504 (Melde), and Stephen L. Melde, MDTexas A&M University Health Science Center College of Medicine; Temple, TX 76508 (Montoya)Central Texas Veterans Healthcare System; Temple, TX 76504 (Pokala)Central Texas Veterans Healthcare System; Temple, TX 76504 (Melde)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-10-199911160-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Spontaneous retroperitoneal hematoma associated with the use of enoxaparin is not widely reported. A MEDLINE search of the literature from 1966 to April 1999 revealed no cases associated with the current recommended therapeutic dose of 1 mg/kg of body weight every 12 hours (1). We describe a patient who developed a fatal hematoma after use of enoxaparin for acute deep venous thrombosis.A 69-year-old man was transferred to our facility for management of a urinary tract infection. His medical history included ischemic cardiomyopathy, chronic renal insufficiency, localized prostate cancer, and chronic anemia. He had no history of ...References1. Dose-ranging trial of enoxaparin for unstable angina: results of TIMI 11A. The Thrombolysis in Myocardial Infarction (TIMI) 11A Trial Investigators. J Am Coll Cardiol. 1997; 29:1474-82. Google Scholar2. Cohen M, Demers C, Gurfinkel EP, Turpie AG, Fromell GJ, Goodman S, et al . A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. N Engl J Med. 1997;337:447-52. CrossrefMedlineGoogle Scholar3. Noble S, Peters DH, Goa KL. Enoxaparin. A reappraisal of its pharmacology and clinical applications in the prevention and treatment of thromboembolic disease. Drugs. 1995;49:388-410. CrossrefMedlineGoogle Scholar4. Lumpkin MM. FDA public health advisory. Anesthesiology. 1998;88:27A-28A. CrossrefMedlineGoogle Scholar5. Albada J, Nieuwenhuis HK, Sixma JJ. Treatment of acute venous thromboembolism with low molecular weight heparin (Fragmin): results of a double-blind randomized study. Circulation. 1989;80:935-40. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jean-Paul Montoya, MD; Nagaprasadrao Pokala, MD; Stephen L. Melde, MDAffiliations: Texas A&M University Health Science Center College of Medicine; Temple, TX 76508 (Montoya)Central Texas Veterans Healthcare System; Temple, TX 76504 (Pokala)Central Texas Veterans Healthcare System; Temple, TX 76504 (Melde) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNon-traumatic haematoma in a healthy young woman: a case reportSpontaneously resolved gigantic retroperitoneal hematoma following oophorectomy: A case report in a cardiac patient on anticoagulant therapyClinical spectrum of patients with spontaneous retroperitoneal hematomasPerfil clínico de los pacientes con hematomas retroperitoneales espontáneosEnoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcomeConsensus of the Orthopedic Anesthesia, Pain, and Rehabilitation Society on the use of peripheral nerve blocks in patients receiving thromboprophylaxisBilateral spontaneous, simultaneous lower extremity hematomas in a patient on dalteparinSpontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agentsLow molecular weight heparin and fatal spontaneous extraperitoneal hematoma in the elderlyEnoxaparin-Induced Bleeding Resulting in Compartment Syndrome of the Thigh: A Case ReportFatal retroperitoneal hematoma after enoxaparin administration in a patient with paroxysmal atrial flutterComparing Dual Guidance with Ultrasound and Nerve Stimulator in Combination versus Nerve Stimulator Alone for Lumbar Plexus Block and Parasacral Nerve Block in Patients Undergoing Total Knee ArthroplastyGigantic retroperitoneal hematoma as a complication of anticoagulation therapy with heparin in therapeutic doses: a case reportFactors affecting the severity of spontaneous retroperitoneal hemorrhage in anticoagulated patientsRecombinant Activated Factor VII Treatment of Retroperitoneal Hematoma in a Patient with Renal Failure Receiving Enoxaparin and ClopidogrelMassive Retroperitoneal Hematoma During Enoxaparin Treatment of Pulmonary Embolism After Primary Total Hip ArthroplastyAcute and massive hemorrhage due to caval perforation by an inferior vena cava filter—absolute indication for surgery?Is peripheral/plexus block safe in the anticoagulated patient?Enoxaparin-induced psoas hematoma complicated by Staphylococcus aureus infection after cardiac catheterizationSafety of low-dose low-molecular-weight-heparins in thrombocytopenic stem cell transplantation patients: a case series and review of the literatureA Retroperitoneal Bleed Induced by Enoxaparin TherapySPONTANEOUS RETROPERITONEAL HEMATOMAS IN ELDERLY PATIENTS TREATED WITH LOW-MOLECULAR-WEIGHT HEPARINSUse of Heparin Preparations in Older PatientsSurgical Management of Enoxaparin- and/or Warfarin-induced Massive Retroperitoneal Bleeding: Report of a Case and Review of the LiteratureEndovascular Embolization of Spontaneous Retroperitoneal Hemorrhage Secondary to Anticoagulant TreatmentRegional anesthesia and anticoagulationSerious adverse incidents with the usage of low molecular weight heparins in patients with chronic kidney diseaseEnoxaparin-Associated Spontaneous Retroperitoneal Hematoma in Elderly Patients with Impaired Creatinine Clearance: A Report of Two CasesIliopsoas haemorrhage in patients with bleeding disorders - experience from one centreThe Clinical Spectrum of Retroperitoneal Hematoma in Anticoagulated PatientsEnoxaparin-Induced Retroperitoneal HematomaEnoxaparin-related fatal spontaneous retroperitoneal hematoma in the elderlyRectus sheath haematoma with severe haemodynamic compromise after enoxaparin use for unstable anginaRetroperitoneal hematoma following tirofiban and enoxaparin coadministration in a patient with acute coronary syndromeFatal Spontaneous Retroperitoneal Hematoma Secondary to EnoxaparinRetroperitoneal haematoma and tinzaparinRetroperitoneal Haematoma Associated with Low Molecular Weight HeparinHemorragias en pacientes tratados con heparinas de bajo peso molecularHematoma retroperitoneal y enoxaparina en un síndrome coronario agudo sin elevación del STSpontaneous Hemomediastinum Complicating Steroid-Induced Mediastinal LipomatosisRupture of a previously normal spleen in association with enoxaparin: An unusual cause of shockDalteparin-Induced Retroperitoneal Bleeding 16 November 1999Volume 131, Issue 10Page: 796-797KeywordsAnticoagulantsAspirinCoagulopathyComputed axial tomographyDeep vein thrombosisHemoglobinResearch laboratoriesVancomycinVeins ePublished: 15 August 2000 Issue Published: 16 November 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. 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