ENOKSOPARİN KULLANIMINA BAĞLI MASİF REKTUS KILIF HEMATOMU

Öz

Rektus kılıf hematomu; antikoagülasyona bağlı, genellikle ani karın ağrısı başlangıcıyla ortaya çıkan nadir bir komplikasyondur.Düşük molekül ağırlıklı heparin olarak akut koroner sendromlarda yaygın olarak kullanılan Enoksaparin; nadiren karın duvarı hematomuna neden olabilir. Bu komplikasyon potansiyel olarak ölümcüldür ve erken tanı ve tedavi gereklidir. Burada akut koroner sendromda enoksaparin kullanımına bağlı rektus kılıf hematomu olgusu sunuyoruz. Potansiyel tanı ve tedavi yöntemleri literatür ışığında tartışıldı.

Anahtar Kelimeler

• Rectus hematomu, enoksaparin

Kaynakça

1. Antonelli D, Fares L 2nd, Anene C . Enoxaparin associated with huge abdominal wall hematomas: a report of two cases. Am Surg 66: 797-800, 2000.
2. Berna JD, Zuazu I, Madrigal M, Garcia- Medina V, Fernandez C, Guirado F . Conservative treatment of large rectus sheath hematoma in patients undergoing anticoagulant therapy.Abdom Imaging 25:230–234, 2000.
3. Berna JD, Garcia-Medina V, Guirao J, Garcia-Medina J.Rectus sheath hematoma: diagnostic classification by CT. Abdom Imaging 21:62–64, 1996.
4. Dabney A, Bastani B . Enoxaparin-associated severe retroperitoneal bleeding and abdominal compartment syndrome: a report of two cases. J Intensive Care Med 27: 1954-1957, 2001.
5. Di Rosa C, Venora S, Monterosso N, La Spada NM, Viola S .Retroperitoneal hematoma during heparin therapy. Comments on 3 cases. Minerva Chir 52: 493– 497, 1997.
6. Edlow JA, Juang P, Margulies S, Burstein J. Rectus sheath hematoma. Ann Emerg Med 34:671–675, 1999.
7. Katsumori T, Nakajima K . A case of spontaneous hemorrhage of the abdominal wall caused by rupture of a deep iliac circumflex artery treated by transcatheter arterial embolization. Eur Radiol 8:550–552, 1998.
8. Levy JM, Gordon HW, Pitha NR, Nykamp PW Gelfoam embolisation for control of bleeding from rectus sheath haematoma. AJR Am J Roentgenol 135: 1283–1284, 1980.

9. Montoya JP, Pokala N, Melde SL. Retroperitoneal hematoma and enoxaparin. Ann Int Med 131: 796-797, 1999.
10. Moreno Gallego A, Aguayo JL,Flores B, Soria T,Hernandez Q, Ortiz S, Gonzalez-Costea R, Parrilla P.Ultrasonography and computed tomography reduce unnecessary surgery in abdominal rectus sheath haematoma. Br J Surg 84: 1295–1297, 1997.
11. The Columbus investigators Low-molecular-weight heparin in the treatment of patients with venous thromboembolism. N Engl J Med 337:657–62, 1997.
12. Torres GM, Cernigliaro JG, Abbitt PL, Mergo PJ, Hellein VF,. Fernandez S, Ros PR.Iliopsoas compartment: normal anatomy and pathologic processes. Radiographics 15:1285–1297, 1995.
13. Tuncer C, Sokmen G, Guven A, Koleoglu M, Oncel H, Suner A A patient with an acute coronary syndrome and abdominal rectus sheath haematoma mimicking acute coronary syndrome. Anadolu Kardiyol Derg 4: 372-373, 2004.