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Approach to the treatment of spontaneous hemothorax due to the anticoagulant therapy: report of three cases

Year 2012, Volume: 2 Issue: 4, 193 - 196, 01.12.2012
https://doi.org/10.5505/sakaryamj.2012.19483

Abstract

Bleeding is the most important complication of the anticoagulant therapy. The annual risk of bleeding in patients taking warfarin such as; fatal episode is approximately 1%, major episode is 6.5%, and minor bleeding is 21.8%. A small number of hemothorax cases that formed due to anticoagulant therapy, have been reported in the literature. Shock and mortality may be developed in severe bleeding. Hematoma and trapped lung may be occurred, if hemothorax not adequately discharge. When the hemothorax is seen, anticoagulant therapy should be terminated immediately and pleural range to be discharged. In present study, three cases were presented with the literature, which had detected spontaneous hemothorax due to the anticoagulant therapy during the warfarin therapy.

References

  • Estarriol MH, Castillo LAA, Padró XB, Rispau AP, Garay MR, Goday MR. Bilateral Hemothorax Secondary to Combined Anti- platelet Therapy With Clopidogrel and Acetylsalicylic Acid. Arch Bronconeumol. 2006; 42: 307-9.
  • Makris M. Management of excessive anticoagulation or bleeding. Semin Vasc Med 2003; 3: 279-84.
  • Levine MN, Raskob G, Hirsh J. Hemorrhagic complications of long term anticoagulant therapy. Chest 1989; 95 (suppl): 26S-35S.
  • Bircan HA, Sahin U, Akkaya A. Spontaneous hemothorax due to ruptured pulmonary infarction after anticoagulation with enoxapa- rin: a case report. Respiratory 2006; 8: 33-36.
  • Ali HA, Lippmann M, Mundathaje U, Khaleeq G. Spontaneous Hemothorax. Chest 2008; 134; 1056-1065.
  • Rostand RA, Feldman RL, Block ER. Massive hemothorax com- plicating heparin anticoagulation for pulmonary embolus. South Med J 1977; 70: 1128-1130.
  • Mrug M, Mishra PV, Lusane HC, Cunnigham JM, Alpert MA. Hemothorax and retroperitoneal hematoma after anticoagulation with enoxaparin. South Med J 2002; 95: 936-938.
  • Noble S, Peters DH, Goa KL. Enoxaparin. A reapprasial of its phar- macology and clinical applications in the prevention and treat- ment of thromboembolic disease. Drugs 1995;49: 388-410.
  • Antman EM, McCabe CH, Gurfinkel EP, Turpie AG, Berning PJ, Salein D, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wavemyocardial infarction. Re- sults of theThrombolysis in Myocardial Infarction (TIMI) 11B Trial. Circulation 1999; 100: 1593-1601.
  • Wick MR, Ritter JH, Schuller D. Ruptured pulmonary infarction: a rare, fatal complication of thromboembolic disease. Mayo Clin Proc 2000; 75: 639-642.
  • Promisloff RA, Friehling J. Spontaneous hemothorax without pneumothorax. Clin Notes Respir Dis 1982; 21: 13–14.
  • Dimitri WR. Massive idiopathic spontaneous hemothorax: case report and literature review. Eur J Cardiothorac Surg 1987; 1: 55–58.
  • Yung CM, Bessen SC, Hingorani V, Clements NC, Caruso AA. Idi- opathic hemothorax. Chest 1993; 103: 638–639.
  • Oguzkaya F, Akcali Y, Bilgin M. Videothoracoscopy versus intra- pleural streptokinase for management of post traumatic retained haemothorax: a retrospective study of 65 cases. Injury 2005; 36: 526–529.
  • Meyer DM, Jessen ME, Wait MA, Estrera AS. Early evacuation of traumatic retained hemothoraces using thoracoscopy: a pro- spective, randomized trial. Ann Thorac Surg 1997; 64: 1396-400; discussion 1400-1.
  • Ahmed N, Jones D. Video-assisted thoracic surgery: state of the art in trauma care. Injury 2004; 35: 479-89.
  • Jerjes-Sanchez C, Ramirez-Rivera A, Elizalde JJ, Delgado R, Cic- ero R, Ibarra-Perez C, et al. Intrapleural fibrinolysis with streptoki- nase as an adjunctive treatment in hemothorax and empyema: a multicenter trial. Chest 1996; 109: 1514-9.

Antikoagülan tedaviye bağlı gelişen spontan hemotoraksta tedavi yaklaşımı: üç olgu sunumu

Year 2012, Volume: 2 Issue: 4, 193 - 196, 01.12.2012
https://doi.org/10.5505/sakaryamj.2012.19483

Abstract

Antikoagülan tedavinin en önemli komplikasyonu kanamadır. Warfarin alan hastalarda yıllık kanama riski; fatal epizod yaklaşık %1, major epizod %6.5, minör kanama ise %21.8'dir. Literatürde antikoagülan tedaviye bağlı az sayıda spontan hemotoraks olgusu bildirilmiştir. Kanama şiddetli ise şok ve mortalite gelişebilir. Hemotoraks yeterli şekilde boşaltılmazsa hematom ve hapsolmuş akciğer oluşumu riski taşımaktadır. Hemotoraks görüldüğünde antikoagülan tedavi hemen sonlandırılmalı ve plevral aralık boşaltılmalıdır. Bu çalışmada warfarin tedavisine bağlı üç olguda gelişen spontan hemotoraks olgusu literatür bilgileri ışığında sunuldu.

References

  • Estarriol MH, Castillo LAA, Padró XB, Rispau AP, Garay MR, Goday MR. Bilateral Hemothorax Secondary to Combined Anti- platelet Therapy With Clopidogrel and Acetylsalicylic Acid. Arch Bronconeumol. 2006; 42: 307-9.
  • Makris M. Management of excessive anticoagulation or bleeding. Semin Vasc Med 2003; 3: 279-84.
  • Levine MN, Raskob G, Hirsh J. Hemorrhagic complications of long term anticoagulant therapy. Chest 1989; 95 (suppl): 26S-35S.
  • Bircan HA, Sahin U, Akkaya A. Spontaneous hemothorax due to ruptured pulmonary infarction after anticoagulation with enoxapa- rin: a case report. Respiratory 2006; 8: 33-36.
  • Ali HA, Lippmann M, Mundathaje U, Khaleeq G. Spontaneous Hemothorax. Chest 2008; 134; 1056-1065.
  • Rostand RA, Feldman RL, Block ER. Massive hemothorax com- plicating heparin anticoagulation for pulmonary embolus. South Med J 1977; 70: 1128-1130.
  • Mrug M, Mishra PV, Lusane HC, Cunnigham JM, Alpert MA. Hemothorax and retroperitoneal hematoma after anticoagulation with enoxaparin. South Med J 2002; 95: 936-938.
  • Noble S, Peters DH, Goa KL. Enoxaparin. A reapprasial of its phar- macology and clinical applications in the prevention and treat- ment of thromboembolic disease. Drugs 1995;49: 388-410.
  • Antman EM, McCabe CH, Gurfinkel EP, Turpie AG, Berning PJ, Salein D, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wavemyocardial infarction. Re- sults of theThrombolysis in Myocardial Infarction (TIMI) 11B Trial. Circulation 1999; 100: 1593-1601.
  • Wick MR, Ritter JH, Schuller D. Ruptured pulmonary infarction: a rare, fatal complication of thromboembolic disease. Mayo Clin Proc 2000; 75: 639-642.
  • Promisloff RA, Friehling J. Spontaneous hemothorax without pneumothorax. Clin Notes Respir Dis 1982; 21: 13–14.
  • Dimitri WR. Massive idiopathic spontaneous hemothorax: case report and literature review. Eur J Cardiothorac Surg 1987; 1: 55–58.
  • Yung CM, Bessen SC, Hingorani V, Clements NC, Caruso AA. Idi- opathic hemothorax. Chest 1993; 103: 638–639.
  • Oguzkaya F, Akcali Y, Bilgin M. Videothoracoscopy versus intra- pleural streptokinase for management of post traumatic retained haemothorax: a retrospective study of 65 cases. Injury 2005; 36: 526–529.
  • Meyer DM, Jessen ME, Wait MA, Estrera AS. Early evacuation of traumatic retained hemothoraces using thoracoscopy: a pro- spective, randomized trial. Ann Thorac Surg 1997; 64: 1396-400; discussion 1400-1.
  • Ahmed N, Jones D. Video-assisted thoracic surgery: state of the art in trauma care. Injury 2004; 35: 479-89.
  • Jerjes-Sanchez C, Ramirez-Rivera A, Elizalde JJ, Delgado R, Cic- ero R, Ibarra-Perez C, et al. Intrapleural fibrinolysis with streptoki- nase as an adjunctive treatment in hemothorax and empyema: a multicenter trial. Chest 1996; 109: 1514-9.
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Yener Aydın This is me

Murat Aydın This is me

Hasan Kaynar This is me

Atila Türkyılmaz This is me

Atilla Eroğlu This is me

Publication Date December 1, 2012
Submission Date September 7, 2015
Published in Issue Year 2012 Volume: 2 Issue: 4

Cite

AMA Aydın Y, Aydın M, Kaynar H, Türkyılmaz A, Eroğlu A. Antikoagülan tedaviye bağlı gelişen spontan hemotoraksta tedavi yaklaşımı: üç olgu sunumu. Sakarya Tıp Dergisi. December 2012;2(4):193-196. doi:10.5505/sakaryamj.2012.19483

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