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Updated: Aug 6, 2026
06:33
Massive Pontine Hemorrhage by Dual Injection of Autologous Blood
Published on: May 29, 2021
Life-threatening hematoma associated with paracentesis: a case report
Siva K Mulpuru1, Naresh A Mori, Robert L Levey
1Department of Internal Medicine, Long Island College Hospital, Brooklyn, New York 11201, USA.
Summary
Unfractionated heparin for deep venous thrombosis prophylaxis can cause rectus sheath hematoma after paracentesis. Use heparin cautiously in patients undergoing this procedure to prevent complications.
Area of Science:
- Internal Medicine
- Hematology
- Gastroenterology
Background:
- Deep venous thrombosis (DVT) prophylaxis is standard for high-risk medical patients.
- Paracentesis is a common procedure for fluid removal in certain medical conditions.
Observation:
- A patient receiving unfractionated heparin for DVT prophylaxis developed a large rectus sheath hematoma and hypotension post-paracentesis.
- This complication was unique and developed gradually after the procedure.
Findings:
- Unfractionated heparin, while crucial for DVT prophylaxis, poses a risk for rectus sheath hematoma formation during paracentesis.
- The combination of heparin and paracentesis requires careful consideration due to potential bleeding complications.
Implications:
- Clinicians should exercise caution when prescribing unfractionated heparin for DVT prophylaxis in patients undergoing paracentesis.
- This case highlights the importance of risk-benefit assessment for anticoagulation in patients undergoing invasive procedures.
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