Mesenteric Ischemia Caused by Heparin-induced Thrombocytopenia: A Case Report

Deep venous thrombosis (DVT) prophylaxis is the current standard of care in trauma patients. While most of the anticoagulation complications are obvious and can be promptly identified, heparin-induced thrombocytopenia (HIT) requires a high index of suspicion for early diagnosis to prevent a potentially fatal outcome. A 39-year-old female presented to our emergency room after sustaining a gunshot wound to her left flank and pelvis requiring a sigmoid colon and left fallopian tube and ovary resection with colostomy diversion. The patient did well in her early postoperative period; however, her condition rapidly deteriorated after that as a result of mesenteric ischemia caused by heparin-induced thrombocytopenia. After multiple visits to the operating room, the patient ended up with short bowel syndrome, necessitating a referral to a bowel transplant center. Our aim is to increase awareness of this potentially lethal complication with a mortality rate up to 30% of patients.