Spontaneous abdomen and abdominal wall hematomas due to anticoagulant/antiplatelet use; Single center, surgeons perspective

Çolakoğlu, Muhammet Kadri; Özdemir, Ali; Kalcan, Süleyman; Demir, Adem; Demiral, Gökhan; Pergel, Ahmet

doi:10.14744/tjtes.2019.32485

Cited by 13 publications

(18 citation statements)

References 6 publications

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“…Possible risk factors for RSH are trauma, rapid and sudden changes in position, anticoagulant therapy, some hematologic diseases which disrupt blood clotting mechanisms, von Willebrand disease, hypertension, obesity, recent anterior abdominal wall surgery, cough attacks due to asthma and COPD exacerbations, injections, and pregnancy. 6,7,9 Anticoagulant therapy has been identified as the most commonly reported risk factor for RSH. 1,2,6,9,10 Patients with cardiovascular diseases and an ASA score of 3 made up the great majority of our series.…”

Section: Discussionmentioning

confidence: 99%

“…7 In the literature, data relating to rectus sheath hematoma are based on single center experiences and series with limited number of patients. 3,[7][8][9][10] In this study; we aim to analyze and discuss, in the light of the literature, the clinical features of patients diagnosed with rectus sheath hematoma in our clinic over a period of 10 years, and the therapeutic management and therapeutic results of SRSH.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors in the Development of Rectus Sheath Hematoma and Treatment Modalities

Dalcı

Topal

Saritaş

et al. 2020

Preprint

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Aim: In this study,we aim to present the clinical features of patients with Rectus Sheath Hematoma (RSH), therapeutic management and results. Methods: The study included patients who were diagnosed with and received treatment due to spontaneous rectus sheath hematoma between the years 2010 and 2020. The demographic and clinical features of the patients,history of anticoagulant drug use and indication for anticoagulant drugs, laboratory parameters and radiological findings at the time of admission to the hospital, diameter of the hematoma, treatment modalities, follow-up parameters were analyzed retrospectively. Results: Our study included fifty-three patients. The median age was 65.7±14,68 years and 63.3% of the patients were over the age of 65 years. Number of female patients was 35. Cases most often had an American Society of Anesthesiologists score of 3 (64.3%). The most frequently used anticoagulant was warfarin (30.1%) and it was most often used due to heart diseases (54.7%).International Normalized Ratio value at the time of admission to the hospital was 1.93+1.18 and the hemoglobin value was 11.2 gr/dl. Average hematoma diameter was 74 mm and the most common stage was Type 1 (75.6%). 90.6% of the patients were followed up conservatively. Average duration of hospital stay being 15.1 days, mortality developed in 8 patients during their hospital stay. Conclusion: Spontaneous RSH should come to mind in elderly female patients who apply to the hospital with acute abdominal pain and are on anticoagulant therapy. Suspecting RSH can render early and true diagnosis possible, thus reducing morbidity and mortality in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors in the Development of Rectus Sheath Hematoma and Treatment Modalities

Dalcı

Topal

Saritaş

et al. 2020

Preprint

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“…Whether RSH diagnosis is confirmed, the patient's clinical status should determine principally what therapeutic decision will be made, either conservative or invasive, through arterial embolization or even open surgical intervention. Recent evidence suggests that conservative care is the choice of treatment of spontaneous abdominal wall hematoma due to anticoagulant/antiplatelet use, whereas an invasive intervention should always be kept in mind for hemodynamically unstable patients [19]. Contrella and colleagues have also evaluated the radiographic, laboratory, and clinical factors associated with conservative management failure in a retrospective study of 72 patients with spontaneous RSH.…”

Section: Discussionmentioning

confidence: 99%

Fondaparinux–Associated Rectus Sheath Hematoma: Skating on Thin Ice

Sabanis¹,

Drylli

Mamakou³

et al. 2020

Cureus

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Rectus sheath hematoma (RSH), an exceptionally rare clinical entity, results from the rupture of epigastric arteries or tear of the rectus abdominis muscle itself. Spontaneous RSH represents a potentially life-threatening bleeding complication in anticoagulated patients with distinct characteristics. The non-specific nature of RSH clinical manifestations renders RSH a kaleidoscopic disease that may be misdiagnosed. The widespread use of anticoagulants for deep vein thrombosis (DVT) prophylaxis or therapy is among the most commonly documented risk factors. To the best of our knowledge, this is the first report of a fondaparinux-associated giant RSH in a 58-year-old Caucasian man who presented with severe pain at the right abdominal quadrant accompanied with a large ecchymosis secondary to violent cough due to a respiratory infection. The aim of our study is to broaden current knowledge regarding the predisposing factors, the pathophysiological mechanisms, and the management of this bleeding disorder.

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“…Se valoraron también las posibles interacciones farmacológicas para este cambio de tratamiento 8 . Sin embargo, el uso de HBPM no está exento de riesgos, como son los hematomas abdominales [9][10][11] , por lo que debemos ser extremadamente cautelosos en este tipo de pacientes. De hecho, en las recomendaciones de la Sociedad Española de Cardiología ya se apunta que no hay evidencia clara sobre el mantenimiento de la anticoagulación oral de los pacientes que ingresan por infección por SARS-CoV-2, aunque sugieren que a priori se podría mantener en aquellos pacientes estables y que no toman ningún fármaco potencialmente causante de una interacción.…”

Section: Discussionunclassified

Learning with COVID-19: what about anticoagulation?

Álvarez-Rodríguez

González

Torres-Gárate

et al. 2020

An Sist Sanit Navar

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La infección por SARS-CoV-2 (COVID-19) se rela ciona con un aumento del riesgo de enfermedad tromboembólica. Algunos autores recomiendan la anticoagulación en dosis terapéuticas de, al menos, los pacientes más graves, práctica no exenta de riesgos, por lo que otros consensos solo recomiendan la profilaxis tromboembólica. La recomendación generalizada en pacientes previamente anticoagulados es el cambio del anticoagulante oral por heparina de bajo peso molecular (HBPM). Presentamos dos pacientes ingresados por CO-VID-19 sin datos de gravedad, en los que se sustituyó la anticoagulación (acenocumarol en un caso y rivaroxabán en el otro) por HBPM a dosis terapéuticas, presentando ambos sangrados abdominales. Estos sangrados son una complicación infrecuente en pacientes anticoagulados, pero la concurrencia de dos casos en un breve espacio de tiempo en el contexto de la pandemia por COVID-19 nos plantea que aún no se dispone de una evidencia clara sobre la anticoagulación terapéutica en la infección por SARS-CoV-2. Palabras clave. SARS-CoV-2. COVID-19. Anticoagulación. Hematoma abdominal.

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Spontaneous abdomen and abdominal wall hematomas due to anticoagulant/antiplatelet use; Single center, surgeons perspective

Cited by 13 publications

References 6 publications

Risk Factors in the Development of Rectus Sheath Hematoma and Treatment Modalities

Risk Factors in the Development of Rectus Sheath Hematoma and Treatment Modalities

Fondaparinux–Associated Rectus Sheath Hematoma: Skating on Thin Ice

Learning with COVID-19: what about anticoagulation?

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