• Am J Emerg Med · Dec 2014

    Review Case Reports

    Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome.

    • Nikolaos S Salemis, Ioannis Oikonomakis, Emanuel Lagoudianakis, Georgios Boubousis, Christos Tsakalakis, Sotirios Sourlas, and Stavros Gourgiotis.
    • Second Department of Surgery, 401 Army General Hospital, Athens, Greece. Electronic address: nikos_salemis@hotmail.com.
    • Am J Emerg Med. 2014 Dec 1;32(12):1559.e1-3.

    AbstractSpontaneous retroperitoneal hematoma (SRH) is a severe and potentially fatal complication of anticoagulation therapy. We describe a case of fatal spontaneous massive retroperitoneal hematoma in a female patient receiving bridging therapy with enoxaparin for atrial fibrillation. Physicians should be cautious when prescribing enoxaparin in elderly patients, in patients with impaired renal function, and in patients receiving concomitant oral anticoagulants. Emergency physicians should always consider SRH in the differential diagnosis in patients under enoxaparin therapy presenting with abdominal pain. Computed tomographic scan is the imaging modality of choice for evaluating SRH. Early diagnosis and aggressive treatment are of paramount importance as SRH is associated with high mortality and morbidity rates.

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