Abdominal Compartment Syndrome Due to Warfarin-Related Retroperitoneal Hematoma

Andrade, Mônica Mourthé de Alvim; Pimenta, Marcelo; Belezia, Bruno de Freitas; Xavier, Rafael Lodi; Neiva, Augusto Motta

doi:10.1590/s1807-59322007000600019

Cited by 11 publications

(3 citation statements)

References 13 publications

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“…To prevent end-organ failure and to decrease mortality, frequent IAP monitoring and timely surgical decompression are mandatory. Although there have been some reports about ACS combined with anticoagulation-related SRH,2,16,17 our current case is only the second reported case of ACS due to warfarin-related SRH 18…”

Section: Discussionmentioning

confidence: 69%

Abdominal Compartment Syndrome Due to Spontaneous Retroperitoneal Hemorrhage in a Patient Undergoing Anticoagulation

et al. 2011

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Spontaneous retroperitoneal hemorrhage is one of the most serious and often lethal complications of anticoagulation therapy. The clinical symptoms vary from femoral neuropathy to abdominal compartment syndrome or fatal hypovolemic shock. Of these symptoms, abdominal compartment syndrome is the most serious of all, because it leads to anuria, worsening of renal failure, a decrease in cardiac output, respiratory failure, and intestinal ischemia. We report a case of a spontaneous retroperitoneal hemorrhage in a 48-year-old female who had been receiving warfarin and aspirin for her artificial aortic valve. She presented with a sudden onset of lower abdominal pain, dizziness and a palpable abdominal mass after prolonged straining to defecate. Computed tomography demonstrated a huge retroperitoneal hematoma and active bleeding from the right internal iliac artery. After achieving successful bleeding control with transcatheter arterial embolization, surgical decompression of the hematoma was performed for management of the femoral neuropathy and the abdominal compartment syndrome. She recovered without any complications. We suggest that initial hemostasis by transcatheter arterial embolization followed by surgical decompression of hematoma is a safe, effective treatment method for a spontaneous retroperitoneal hemorrhage complicated with intractable pain, femoral neuropathy, or abdominal compartment syndrome.

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Section: Discussionmentioning

confidence: 69%

Abdominal Compartment Syndrome Due to Spontaneous Retroperitoneal Hemorrhage in a Patient Undergoing Anticoagulation

et al. 2011

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“…Conversely, Milanchi and colleagues noted the failure of simple evacuation, which required reoperation and formal evacuation within eight hours. Andrade and colleagues [35] also reported a case of RH with ACS in which they simply decompressed the peritoneum with a Bogotta bag, and subsequently closed the abdominal cavity over a month without reporting on the specific renal status. …”

Section: Discussionmentioning

confidence: 99%

Correct the Coagulopathy and Scoop It Out: Complete Reversal of Anuric Renal Failure through the Operative Decompression of Extraperitoneal Hematoma-Induced Abdominal Compartment Syndrome

McBeth

Dunham

Ball

et al. 2012

Case Reports in Medicine

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We report two cases of extraperitoneal compression of the intra-abdominal space resulting in abdominal compartment syndrome (ACS) with overt renal failure, which responded to operative decompression of the extra-peritoneal spaces. This discussion includes patient presentation, clinical course, diagnosis, interventions, and outcomes. Data was collected from the patient's electronic medical record and a radiology database. ACS appears to be a rare but completely reversible complication of both retroperitoneal hematoma (RH) and rectus sheath hematoma (RSH). In patients with large RH or RSH consideration of intra-abdominal pressure (IAP) monitoring combined with aggressive operative drainage after correction of the coagulopathy should be considered. These two cases illustrate how a relatively benign pathology can result in increased IAP, organ failure, and ultimately ACS. Intervention with decompressive laparotomy and evacuation of clot resulted in return to normal physiologic function.

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“…There have been many reports of gastrointestinal hemorrhage during treatment with warfarin potassium [1][2][3][4]. In patients on anticoagulant therapy after mechanical valve replacement, anticoagulant therapy cannot be discontinued even if aortic dissection occurs and bleeding may have a very serious outcome.…”

Section: Discussionmentioning

confidence: 99%

Rupture of pseudoaneurysm of the pancreaticoduodenal arcade after acute aortic dissection in a patient on anticoagulant therapy

Taniai

Nagai

Shimizu

et al. 2011

Journal of Cardiology Cases

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An 81-year-old woman on anticoagulant therapy after mechanical heart valve replacement was admitted because of acute aortic dissection. Anticoagulant therapy had to be continued with heparin even after admission. Gastrointestinal hemorrhage occurred suddenly and she developed hemorrhagic shock. Computed tomography findings suggested that the bleeding was due to rupture of a pseudoaneurysm of the pancreaticoduodenal arcade. After the site of bleeding was identified by angiography, hemorrhage was successfully controlled by embolization with coils. With the aging of the population, vascular complications of arteriosclerosis are likely to increase. This case report provides important insights that could be helpful for treating such patients.

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Abdominal Compartment Syndrome Due to Warfarin-Related Retroperitoneal Hematoma

Cited by 11 publications

References 13 publications

Abdominal Compartment Syndrome Due to Spontaneous Retroperitoneal Hemorrhage in a Patient Undergoing Anticoagulation

Abdominal Compartment Syndrome Due to Spontaneous Retroperitoneal Hemorrhage in a Patient Undergoing Anticoagulation

Correct the Coagulopathy and Scoop It Out: Complete Reversal of Anuric Renal Failure through the Operative Decompression of Extraperitoneal Hematoma-Induced Abdominal Compartment Syndrome

Rupture of pseudoaneurysm of the pancreaticoduodenal arcade after acute aortic dissection in a patient on anticoagulant therapy

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