Enoxaparin (a low molecular weight heparin) has been used extensively for its antithrombotic properties. Complications of its haemorrhagic side-effects have previously been described. We report two cases of extensive retroperitoneal haematoma requiring blood transfusion and inotropic support. One patient developed acute renal failure and did not respond to intensive resuscitative efforts.
AguilarD., GoldhaberS.Z.Clinical uses of low-molecular-weight heparins.Chest1999; 115: 1418–1423.
2.
LevineM.N., HirshJ.Hemorrhagic complications of anticoagulant therapy.Semin Thromb Hemost1986; 12: 39–57.
3.
VandermeulenE.P.Van Aken H, Vermylen J. Anticoagulants and spinal-epidural anesthesia.Anesth Analg1994; 79: 1165–1177.
4.
BergqvistD., LindbladB., MatzschT.Low molecular weight heparin for thromboprophylaxis and epidural/spinal anaesthesia—is there a risk?Acta Anaesthesiol Scand1992; 36: 605–609.
5.
MontoyaJ.P., PokalaN., MeldeS.L.Retroperitoneal hematoma and enoxaparin.Ann Intern Med1999; 131: 796–797.
6.
AntonelliD., FaresA., AneneC.Enoxaparin associated with huge abdominal wall hematomas: a report of two cases.Am Surg2000; 66: 797–800.
7.
LumpkinM.M.FDA public health advisory.Anesthesiology1998; 88: 27A–28A.
8.
HoudeJ.P., SteinbergG.Intrahepatic hemorrhage after use of low-molecular-weight heparin for total hip arthroplasty.J Arthroplasty1999; 14: 372–374.
9.
KleinS.M., D'ErcoleF., GreengrassR.A., WarnerD.S.Enoxaparin associated with psoas hematoma and lumbar plexopathy after lumbar plexus block.Anesthesiology1997; 87: 1576–1579.
10.
BrophyD.F., WaznyL.D., GehrT.W., ComstockT.J., VenitzJ.The pharmacokinetics of subcutaneous enoxaparin in end-stage renal disease.Pharmacotherapy2001; 21: 169–174.
11.
GerlachA.T., PickworthK.K., SethS.K., TannaS.B., BarnesJ.F.Enoxaparin and bleeding complications: a review of patients with and without renal insufficiency.Pharmacotherapy2000; 20: 771–775.
