Heparin-induced rectus sheath hematoma in a COVID-19 patient with pulmonary emboli: a case report and literature review
Iranian Red Crescent Medical Journal
; 24(4), 2022.
Article
in English
| CAB Abstracts | ID: covidwho-1876520
ABSTRACT
Introduction:
Rectus sheath hematoma (RSH) is an uncommon cause of acute abdominal pain that is often misinterpreted. Only about 2% of patients who present with acute abdominal pain display this condition. Damage to the superior or inferior epigastric arteries or their branches, as well as direct rupture of the rectus abdominis muscle, causes bleeding into the rectus sheath. In hospitalized COVID-19 patients, anticoagulant prophylaxis with heparin has become a standard part of medical care. This method may raise the risk of bleeding in older people with comorbidities. Case presentation The patient was a 60-year-old woman with a history of asthma and diabetes mellitus who was referred to the emergency department with shortness of breath and cough. Chest X-Ray demonstrated Covid-19 pneumonia. On the second day of hospitalization, after the exacerbation of tachypnea, computed tomography (CT) angiography was performed, and the results confirmed pulmonary embolism;therefore, the therapeutic dose of heparin was initiated. On the 21st day of hospitalization, the patient experienced abdominal pain and was visited by a general surgeon. A large ecchymosis was observed in the periumbilical;nonetheless, there was no significant tenderness in the abdominal exam. The patient's hemoglobin dropped to 7.9 mg/dl at this time. An abdominal and pelvic CT scan showed a 45 mm hematoma in the left rectus muscle.
Non-communicable Human Diseases and Injuries [VV600]; Prion, Viral, Bacterial and Fungal Pathogens of Humans [VV210]; Health Services [UU350]; human diseases; case reports; clinical aspects; abdomen; anticoagulants; asthma; comorbidity; computed tomography; diabetes mellitus; differential diagnosis; disease prevention; early treatment; elderly; embolism; haematoma; haemoglobin; health care; health services; heparin; hospital stay; hospitals; literature reviews; lungs; medical services; medical treatment; muscles; pain; physicians; pneumonia; prophylaxis; radiography; rectus sheath; surgeons; surgery; therapy; thorax; women; viral diseases; coronavirus disease 2019; man; Severe acute respiratory syndrome coronavirus 2; Iran; Homo; Hominidae; primates; mammals; vertebrates; Chordata; animals; eukaryotes; Severe acute respiratory syndrome-related coronavirus; Betacoronavirus; Coronavirinae; Coronaviridae; Nidovirales; positive-sense ssRNA Viruses; ssRNA Viruses; RNA Viruses; viruses; high Human Development Index countries; lower-middle income countries; Middle East; West Asia; Asia; hematoma; SARS-CoV-2; clinical picture; aged; elderly people; older adults; senior citizens; hemoglobin; heparin sulfate; heparin sulphate; doctors; therapeutics; viral infections
Full text:
Available
Collection:
Databases of international organizations
Database:
CAB Abstracts
Type of study:
Case report
/
Reviews
Language:
English
Journal:
Iranian Red Crescent Medical Journal
Year:
2022
Document Type:
Article
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