Bir COVID-19 Hastasında Profilaktik Subkutan Enoksaparin Tedavisi Sonrası Rektus Kılıf Hematomu

Abstract

COVID-19, solunum yetmezliği ile birlikte mikrovasküler tromboza neden olan bir hastalıktır. Antikoagülan tedaviler bazen yaşamı tehdit eden gastrointestinal, intrakraniyal ve abdominal kanamaya neden olur.68 yaşındaki erkek hasta, acil serviste yapılan COVID-19 PCR-RT testinin pozitif olması ve toraks tomografisinde COVID-19 pnömonisi ile uyumlu olması nedeniyle enfeksiyon hastalıkları servisine kabul edildi. Hastanın hipertansiyon ve koroner arter hastalığına bağlı mikrovasküler tromboz riskinin yüksek olacağı düşünülerek profilaktik subkutan enoksaparin tedavisi başlandı. Tedavisinin 10. gününde, genel durumu kötüleşen ve şiddetli karın ağrısı gelişmesi üzerine, tanı amaçlı olarak bakılan hemoglobin incelemesinde hemoglobin 6,4 mg/dl,ve batın tomografisinde ise rektus kılıfından başlayarak pelvise yayılan 15x11x14 cm abadlı hematom tespit edilmesi üzerine rektus kılıf hematomu tanısı konuldu.

Keywords

• COVID-19
• hematom
• enoksaparinsodyum
• bilgisaraylı tomografi

Rectus Sheath Hematoma After Prophylactic Subcutaneous Enoxaparin Treatment in a COVID-19 Patient

Abstract

COVID-19 is a disease that causes microvascular thrombosis with respiratory failure. Anticoagulant treatments sometimes cause life-threatening gastrointestinal, intracranial, and abdominal bleeding. A 68-year-old male patient was admitted to the infectious diseases service because the COVID-19 PCR-RT test performed in the emergency department was positive and it was compatible with COVID-19 pneumonia on thoracic tomography. Prophylactic subcutaneous enoxaparin treatment was initiated considering that the patient would have a high risk of microvascular thrombosis due to hypertension and coronary artery disease. On the 10th day of his treatment, the patient whose general condition was deteriorated and had severe abdominal pain, hemoglobin was 6.4 mg/dl in the hemoglobin examination performed for diagnosis, and a diagnosis of hematoma spreading to the pelvis starting from the rectus sheath of 15x11x14 cm was made in abdominal tomography.

Keywords

• COVID-19
• hematoma
• enoxaparinsodium
• computed tomography.

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