Intrahepatic hemorrhage after use of low-molecular-weight heparin for total hip arthroplasty

Houde, John P.; Steinberg, Gerald G.

doi:10.1016/s0883-5403(99)90065-7

Cited by 20 publications

(12 citation statements)

References 8 publications

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“…Other cases involved intravenous heparin therapy for a pulmonary embolism and prophylactic dose of low-molecular-weight heparin for a total hip arthroplasty. 13, 14 In these cases, the liver hemorrhages occurred soon after administration of antiplatelet agents. Subcapsular hematomas have also been reported as a complication in warfarin therapy.…”

Section: Discussionmentioning

confidence: 99%

Dual Antiplatelet Agent—Induced Spontaneous Liver Hematoma

Darwish

Iqbal

2012

Ann Pharmacother

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Section: Discussionmentioning

confidence: 99%

Dual Antiplatelet Agent—Induced Spontaneous Liver Hematoma

Darwish

Iqbal

2012

Ann Pharmacother

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“…LMWH-associated hemorrhages in the absence of any trauma range from lower extremity, abdominal wall, and retroperitoneal hematomas to spontaneous splenic rupture [1,5,6]. Spontaneous intrahepatic bleeding is exceptional and only very few cases have been described [7]. Here we present a unique case of fatal intrahepatic hematoma and subsequent spontaneous bleeding from the liver surface complicating nadroparin use in a patient with a hepatic cyst.…”

Section: Introductionmentioning

confidence: 93%

Fatal intrahepatic hemorrhage after nadroparin use for total hip arthroplasty

Ventura

Bonsignore

Stefano

et al. 2014

Forensic Sci Med Pathol

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Low-molecular-weight heparins have become the predominant choice for deep venous thrombosis prophylaxis and treatment. However, their use may cause bleeding complications. Intrahepatic bleeding is exceptional and only very few cases have been described. The authors present a unique case of fatal intrahepatic hematoma complicating nadroparin use in a 65-year-old woman with a hepatic cyst who was admitted to hospital for unilateral total hip arthroplasty. At autopsy, hemoperitoneum (2,000 ml of blood and clots) was evident. A ruptured sub-capsular hematoma involving the right lobe of the liver was observed. The hemorrhage within the cyst induced by the nadroparin use was likely responsible for the subsequent hepatic hematoma, liver rupture, and death. This case highlights the need for pathologists and surgeons to be aware of the possibility of intrahepatic hematoma in patients who have received low-molecular-weight heparins, undergone major surgery and present postoperative hemodynamic instability, especially in those with preoperative diagnosis of hepatic cyst.

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“…La incidencia de complicaciones hemorrágicas asociadas a la utilización de HBPM no se conoce con exactitud al ser descritos únicamente casos aislados de hemorragia intrahepática, hematomas del psoas, pared abdominal, retroperitoneal y epidural, éste último tras procedimientos de anestesia epidural (8,9).…”

Section: Repisounclassified