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Dalteparin-associated catastrophic retroperitoneal hematoma successfully treated with recombinant factor VIIa

  • Urology – Case Report
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Abstract

Low-molecular-weight heparins (LMWHs) have been widely used in many clinical settings. LMWH-associated spontaneous retroperitoneal hematoma (SRH) has been reported mostly in patients treated with enoxaparin. We here present a 76-year-old man with renal insufficiency treated with dalteparin for acute myocardial infarction, who developed catastrophic SRH with intra-abdominal hypertension (IAH) and hemothorax. Because of the high risk of surgical intervention, we performed ultrasound-guided abdominal paracentesis and thoracentesis to relieve IAH and respiratory distress. Vigorous supportive care with massive blood product transfusions was given to stabilize his hemodynamics. Finally, the bleeding was stopped with a powerful hemostatic agent, recombinant factor VIIa. Surgical evacuation of a 3,600 mL blood clot was performed successfully 1 month later.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Tri-Service General Hospital, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan

    Ching-Hsun Wang & Sung-Sen Yang

  2. Division of Hematology and Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Yeu-Chin Chen

  3. Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Chih-Wei Tsao

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  1. Ching-Hsun Wang
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  2. Yeu-Chin Chen
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  3. Chih-Wei Tsao
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  4. Sung-Sen Yang
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Correspondence to Sung-Sen Yang.

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Wang, CH., Chen, YC., Tsao, CW. et al. Dalteparin-associated catastrophic retroperitoneal hematoma successfully treated with recombinant factor VIIa. Int Urol Nephrol 44, 1091–1095 (2012). https://doi.org/10.1007/s11255-011-0104-x

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  • DOI: https://doi.org/10.1007/s11255-011-0104-x

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