Spontaneous subcutaneous tissue haematoma associated with warfarin

Pinheiro, Nuno Cercas; Lopes, Ana; Camões, A.; Monteiro, Micaela Seemann

doi:10.1136/bcr-2016-215134

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…In severe cases, correction of coagulation disorder using phytomenadione and fresh frozen plasma may be needed. 8 In our case, the hematoma manifested after a direct injury to the groin because of trauma with previous consumption of warfarin.…”

Section: Discussionmentioning

confidence: 72%

Neglected Traumatic Vulvar Hematoma: A Case Report

Pratama,

Riani,

Mardjuki

et al. 2024

Obgynia

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Introduction: Vulvar hematoma is a rare condition that can arise from many causes. In serious cases, the patient is hemodynamically unstable and requires immediate treatment. Multiple factors from patients and health care providers impact the outcome.Case Illustration: P1A0A0 60-year-old womapresentedme to the outpatient clinic with a painful lump in her vulva for 1 month after trauma and observation in primary care. She had previously consumed anticoagulants for venous insufficiency. Her family’s socioeconomic status was relatively poor. She did not have a complete comprehension of her illness. Physical examination revealed left major labia hematoma with a size of 5 10 cm, which was confirmed with ultrasonography. Incision and clot evacuation were performed under general anesthesia and showed a good outcome.Discussion: Vulva is an external part of female genitalia composed of smooth muscle and loose connective tissue with rich vascularization. This organ is prone to hematoma, and there is no consensus published yet. In this patient, the treatment was delayed for 1 month because of a failure to disseminate a clear care plan combined with the patient’s low literacy.Conclusion: Vulvar hematoma is a rare case that can be treated with a conservative, surgical, or embolization approach. Neglected cases can become chronic hematomas that lead to difficulties in diagnosis. A clear care plan should be successfully disseminated to the patient despite many communication challenges to ensure fast and appropriate medical treatment.Hematoma Vulva Traumatik Terbengkalai : Laporan KasusAbstrakPendahuluan: Hematoma vulva adalah kasus jarang yang dapat timbul karena berbagai macam penyebab. Pada kasus yang berat, pasien dapat mengalami hemodinamik yang tak stabil dan memerlukan tatalaksana secepatnya. Berbagai macam faktor dari pasien dan tenaga kesehatan mempengaruhi hasil pengobatan.Ilustrasi Kasus: Wanita P1A0 usia 60 tahun datang ke poliklinik dengan benjolan yang menyebabkan nyeri pada vulva 1 bulan pasca trauma yang telah diobservasi di pelayanan primer. Pasien sebelumnya mengkonsumsi antikoagulan untuk insufisiensi vena. Sosioekonomi keluarga pasien relatif rendah. Pemeriksaan fisik menunjukkan hematoma labia mayor berukuran 5 x 10 cm yang dikonfirmasi dengan ultrasonografi. Pada pasien ini dilakukan insisi dan evakuasi gumpalan darah dibawah anestesi umum yang menunjukkan hasil yang baik.Diskusi: Vulva adalah organ genitalia eksternal wanita yang tersusun atas otot polos dan jaringan ikat longgar yang kaya vaskularisasi. Organ ini rentan mengalami hematoma dan saat ini belum terdapat konsensus. Penanganan pada pasien ini terlambat selama 1 bulan karena rencana penanganan yang tidak tersampaikan kepada pasien yang memiliki literasi kesehatan rendah.Kesimpulan: Hematoma vulva adalah kasus jarang yang dapat ditangani secara konservatif, pembedahan, maupun embolisasi. Kasus terbengkalai dapat menjadi hematoma kronis yang menyulitkan dalam diagnosis. Rencana penatalaksanaan yang jelas harus diberikan kepada pasien dengan segala kesulitan komunikasi demi tatalaksana yang cepat dan tepat.Kata kunci: hematoma vulva, terbengkalai, pemahaman kesehatan, literasi kesehatan rendah

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Section: Discussionmentioning

confidence: 72%

Neglected Traumatic Vulvar Hematoma: A Case Report

Pratama,

Riani,

Mardjuki

et al. 2024

Obgynia

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“…3 Anticoagulation therapy and advanced age are risk factors for traumatic and nontraumatic soft-tissue hemorrhage. 3,14,15 Hematomas can be a direct adverse effect of warfarin therapy, 16 but they are also associated with a broad range of underlying illnesses, including infectious, 17,18 oncologic, 19 hematologic, 3,20 hepatic, 21 and renal 22,23 disease. Identification of active extravasation into a hematoma frequently requires advanced imaging, given the limitations of physically examining often-distorted tissue, and therefore, multiphase CT has become the standard diagnostic tool.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Soft-Tissue Hematomas With Real-Time, Contrast-Enhanced Ultrasound

Kummer¹,

Mohn²,

Bardwell

et al. 2022

Ultrasound Quarterly

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In this study, we investigated the feasibility of using contrastenhanced ultrasound (CEUS) to detect active hemorrhage in patients presenting with soft-tissue hematomas. Adult patients with clinically suspected, actively bleeding hematomas were prospectively enrolled. Contrast-enhanced ultrasound was used to assess for contrast extravasation. Ultrasound results were compared with those of multidetector computed tomographic (MDCT) imaging, operative findings, and clinical course. Sixteen patients (9 women, 7 men; mean age, 69 [SD, 13] years) were enrolled. Thirteen patients underwent MDCT imaging during their initial visit, and for 11, CEUS and computed tomography (CT) findings were concordant. The remaining patients had a negative CEUS study that was consistent with their clinical course. In 8 patients, CT imaging showed active extravasation (6 arterial, 1 indeterminate, 1 slow venous). Contrast-enhanced ultrasound and CT findings were concordant for all cases of arterial bleeding. For 1 patient, CEUS provided superior diagnostic information by identifying a pseudoaneurysm. The 2 discrepant patient cases had a ≥3-hour delay between CT and CEUS, and in 1 patient, CEUS was limited by body habitus. The second patient had no active bleeding identified in the operating room. Compared with CT, CEUS had a sensitivity and specificity of 75% and 100%, respectively, and positive and negative predictive values were 100% and 71%, respectively. Diagnostic accuracy was 85% in this limited study. Contrast-enhanced ultrasound is a promising alternative to MDCT in select patients and may sometimes provide superior clinical information. Limiting factors are large hematoma size, unfavorable anatomic location, and body habitus.

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“…Bu kanamalar cilt hematomu veya subkonjonktival kanama kliniğinde olabileceği gibi intraserebral veya epiglottik kanamalar gibi ciddi morbidite ve mortalite risklerini de beraberinde getirebilir. [4][5][6][7] Hifema, klinik pratiğimizde sıklıkla künt okü-ler travma sonucunda rastladığımız bir durum olmasına rağmen, nadiren warfarin gibi oral antikoagülan kullanımına bağlı, travma öyküsü olmaksızın da karşımıza çıkabilmektedir. Literatürde bu şekilde bildirilmiş olgu sayısı son derece sınırlı-dır.…”

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Warfarin-Related Unilateral Spontaneous Hyphema

İlhan¹

2019

Turkiye Klinikleri J Ophthalmol

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Spontaneous subcutaneous tissue haematoma associated with warfarin

Cited by 6 publications

References 3 publications

Neglected Traumatic Vulvar Hematoma: A Case Report

Neglected Traumatic Vulvar Hematoma: A Case Report

Evaluation of Soft-Tissue Hematomas With Real-Time, Contrast-Enhanced Ultrasound

Warfarin-Related Unilateral Spontaneous Hyphema

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