World J Clin Cases . Retroperitoneal and abdominal bleeding in anticoagulated COVID-19 hospitalized patients: Case series and brief literature review

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World J Clin Cases


. 2023 Mar 6;11(7):1528-1548.
doi: 10.12998/wjcc.v11.i7.1528.
Retroperitoneal and abdominal bleeding in anticoagulated COVID-19 hospitalized patients: Case series and brief literature review


Delian Evrev ^{1 2} , Metodija Sekulovski ^{2 3} , Milena Gulinac ⁴ , Hristo Dobrev ¹ , Tsvetelina Velikova ⁵ , George Hadjidekov ^{2 6}



Affiliations

• PMID: 36926396
• PMCID: PMC10011983
• DOI: 10.12998/wjcc.v11.i7.1528

Abstract

Background: Hospitalized and severely ill coronavirus disease 2019 (COVID-19) patients necessitate prophylactic or therapeutic anticoagulation to minimize the risk of thrombosis at different sites. Life-threatening bleeding complications include spontaneous iliopsoas hematoma, peritoneal bleeding, and extra-abdominal manifestations such as intracranial hemorrhage.
Case summary: Bleeding in the abdominal wall results in less severe complications than seen with iliopsoas hematoma or peritoneal bleeding. In our case series of 9 patients, we present retroperitoneal and abdominal bleeding complications following anticoagulation in hospitalized COVID-19 patients with severe acute respiratory syndrome coronavirus 2 pneumonia. Contrast-enhanced computed tomography (CE-CT) is the best imaging modality for assessing hematoma secondary to anticoagulation and determines the therapeutic approach, whether interventional, surgical, or conservative management.
Conclusion: We present the role of CE-CT for rapid and precise localization of the bleeding site and prognostic counseling. Finally, we provide a brief review of the literature.

Keywords: Abdominal bleeding; Anticoagulation drugs; COVID-19; COVID-19 hospitalized patients; Case report; Case series; Retroperitoneal bleeding.