Life-Threatening Psoas Hematoma due to Retroperitoneal Hemorrhage in a COVID-19 Patient on Enoxaparin Treated With Arterial Embolization: A Case Report
| Autor: | Ishan Patel, Usman Mazahir, Vandan D Upadhyaya, Arda Akoluk, Steven Douedi, Eric J. Costanzo, Daniel Flynn |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Arterial embolization Case Report Lumbar artery bleeding 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Hematoma medicine.artery medicine Embolization Retroperitoneal hemorrhage Enoxaparin Pelvis business.industry Arterial Embolization COVID-19 General Medicine medicine.disease Surgery medicine.anatomical_structure Respiratory failure Abdomen business 030217 neurology & neurosurgery Lumbar arteries |
| Zdroj: | Journal of Clinical Medicine Research |
| ISSN: | 1918-3011 1918-3003 |
| Popis: | Respiratory failure is presumptively caused by microvascular thrombosis in some patients with coronavirus disease 2019 (COVID-19) requiring therapeutic anticoagulation. Anticoagulation treatment may cause life-threatening bleeding complications such as retroperitoneal hemorrhage. To the best of our knowledge, we report first case of a COVID-19 patient treated with therapeutic anticoagulation resulting in psoas hematoma due to lumbar artery bleeding. A 69-year-old patient presented with fever, malaise and progressive shortness of breath to our hospital. He was diagnosed with COVID-19 by RT-PCR. Due to an abnormal coagulation profile, the patient was started on enoxaparin. Over the course of hospitalization, the patient was found to have hypotension with worsening hemoglobin levels. Computed tomography scan of the abdomen and pelvis revealed a large psoas hematoma. Arteriogram revealed lumbar artery bleeding which was treated with embolization. Anticoagulation therapy, while indicated in COVID-19 patients, has its own challenges and guidelines describing dosages and indications in this disease are lacking. Rare bleeding complications such as psoas hematoma should be kept in mind in patients who become hemodynamically unstable, warranting prompt imaging for diagnosis and treatment with arterial embolization, thus eliminating need of surgical intervention. |
| Databáze: | OpenAIRE |
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