tetano
Editor, Senior Moderator
Cureus
. 2022 Jun 24;14(6):e26275.
doi: 10.7759/cureus.26275. eCollection 2022 Jun.
Severe Retroperitoneal Hemorrhage in a COVID-19 Patient on a Therapeutic Dose of Low Molecular Weight Heparin: A Case Report
Martin Dubovský[SUP] 1 2 [/SUP], Marianna Hajská[SUP] 1 2 [/SUP], Arpád Panyko[SUP] 2 1 [/SUP], Marián Vician[SUP] 1 2 [/SUP]
Affiliations
Abstract
Extensive drug treatment for coronavirus disease 2019 (COVID-19) includes low molecular weight heparin (LMWH). At therapeutic doses of LMWH, there is an increased risk of bleeding complications. Spontaneous, non-traumatic bleeding into the retroperitoneum is a life-threatening condition that can progress very rapidly. We describe a complication of COVID-19 bronchopneumonia treatment in which a patient developed a shock condition caused by non-traumatic bleeding into the retroperitoneum and abdominal wall due to LMWH overdose. The patient was operated on under difficult conditions - in biosafety level 3 (BSL-3). This case is exceptionally fascinating and informative. Nowadays, it is essential to point out possible complications associated with the treatment of COVID-19. Based on this report, we emphasize the need for careful LMWH dosing and quick and accurate diagnosis. Surgeons should maintain a higher index of suspicion for spontaneous bleeding in non-specific abdominal pain patients with COVID-19 or patients receiving therapeutic doses of LMWH.
Keywords: anticoagulant therapy; covid-19; lmwh overdose; retroperitoneal hemorrhage; spontaneous bleeding.
. 2022 Jun 24;14(6):e26275.
doi: 10.7759/cureus.26275. eCollection 2022 Jun.
Severe Retroperitoneal Hemorrhage in a COVID-19 Patient on a Therapeutic Dose of Low Molecular Weight Heparin: A Case Report
Martin Dubovský[SUP] 1 2 [/SUP], Marianna Hajská[SUP] 1 2 [/SUP], Arpád Panyko[SUP] 2 1 [/SUP], Marián Vician[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35898364
- PMCID: PMC9308901
- DOI: 10.7759/cureus.26275
Abstract
Extensive drug treatment for coronavirus disease 2019 (COVID-19) includes low molecular weight heparin (LMWH). At therapeutic doses of LMWH, there is an increased risk of bleeding complications. Spontaneous, non-traumatic bleeding into the retroperitoneum is a life-threatening condition that can progress very rapidly. We describe a complication of COVID-19 bronchopneumonia treatment in which a patient developed a shock condition caused by non-traumatic bleeding into the retroperitoneum and abdominal wall due to LMWH overdose. The patient was operated on under difficult conditions - in biosafety level 3 (BSL-3). This case is exceptionally fascinating and informative. Nowadays, it is essential to point out possible complications associated with the treatment of COVID-19. Based on this report, we emphasize the need for careful LMWH dosing and quick and accurate diagnosis. Surgeons should maintain a higher index of suspicion for spontaneous bleeding in non-specific abdominal pain patients with COVID-19 or patients receiving therapeutic doses of LMWH.
Keywords: anticoagulant therapy; covid-19; lmwh overdose; retroperitoneal hemorrhage; spontaneous bleeding.