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Updated: May 10, 2026

Massive Pontine Hemorrhage by Dual Injection of Autologous Blood

Massive Pontine Hemorrhage by Dual Injection of Autologous Blood

Published on: May 29, 2021

Nontraumatic massive spontaneous hemothorax with concomitant warfarin use.

Nurettin Özgür Doğan¹, Gül Pamukçu Günaydın, Mustafa Tekin

¹Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.

Case Reports in Emergency Medicine

|June 14, 2013

Summary

Warfarin overdose can cause rare, life-threatening hemothorax (blood in the chest). This case highlights the importance of monitoring anticoagulation, even without trauma, to prevent severe bleeding complications.

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Last Updated: May 10, 2026

Massive Pontine Hemorrhage by Dual Injection of Autologous Blood

Massive Pontine Hemorrhage by Dual Injection of Autologous Blood

Published on: May 29, 2021

Area of Science:

Medicine
Cardiology
Emergency Medicine

Background:

Hemorrhagic complications are common with warfarin therapy.
Nontraumatic massive hemothorax is an unusual manifestation of warfarin use.

Purpose of the Study:

To report an extremely rare case of massive hemothorax secondary to warfarin overdose in a patient without trauma.
To emphasize the potential for unexpected severe bleeding complications in patients on anticoagulation therapy.

Main Methods:

Case report of a 59-year-old female patient presenting with dyspnea.
Physical examination revealed decreased lung sounds and tachypnea.
Diagnostic workup included computed tomography (CT) of the thorax and international normalized ratio (INR) measurement.

Main Results:

The patient presented with a massive right-sided hemothorax and mediastinal shift, confirmed by CT.
Her INR level was significantly elevated at 12.9, indicating warfarin overdose.
Immediate management included fresh frozen plasma infusion and tube thoracostomy, resulting in drainage of 2000 cc of blood.

Conclusions:

Massive hemothorax is a rare but potentially fatal complication of warfarin overdose.
Prompt diagnosis and management are crucial for favorable outcomes.
This case underscores the need for vigilant monitoring of anticoagulation therapy to prevent severe hemorrhagic events.