Spontaneous Hepatic Hemorrhage: An Unexpected Complication From Enoxaparin

Spontaneous hepatic hemorrhage (SHH) is a rare condition that occurs due to a breach in the liver parenchyma in the absence of an external cause, most commonly from hepatocellular cancer. If a solid liver lesion is absent, then it has been linked with diffuse hepatic diseases or systemic diseases. Although SHH has been linked with the use of warfarin, it has not been thus far linked with enoxaparin. SHH can present with non-specific symptoms, and lab parameters can reveal substantial drops in hemoglobin. It is diagnosed most commonly with computed tomography (CT) imaging and conservative treatment is effective in the majority of cases. We present one such rare case of SHH.