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Rectus sheath haematoma: enoxaparin-related complication

L Velicki1, N Cemerlić-Adić, D Bogdanović

  • 1University of Novi Sad, Medical Faculty, Novi Sad, Serbia. lvelicki@gmail.com

Acta Clinica Belgica
|August 24, 2013
PubMed

Rectus sheath haematoma, an uncommon complication related to subcutaneous administration of enoxaparin, has overall mortality of 4%. Possible mechanisms include unintended intramuscular injection of enoxaparin, and enhanced anticoagulant effect in the elderly and patients with increased bleeding risk. We describe the case of an 80 year-old female patient who was treated after a non-ST-elevated myocardial infarction, with enoxaparin, aspirin and clopidogrel. After a single dose of enoxaparin, the patient developed massive rectus sheath haematoma that was promptly diagnosed and was surgically managed. The patient recovered uneventfully. With incremented use of low-molecular weight heparins in the elderly, one may expect a growing number of bleeding complications.

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