Acta Med. 2012, 55: 47-49

Surgical Management of Severe Spontaneous Hemorrhage of the Abdominal Wall Complicating Acenocoumarol Treatment

Orestis Ioannidisa, George Paraskevasb, Anastasios Kotronisa, Stavros Chatzopoulosa, Athina Konstantaraa, Nikolaos Papadimitrioua, Apostolos Makrantonakisa, Emmanouil Kakoutisa

aFirst Surgical Department, General Regional Hospital 'George Papanikolaou'. Thessaloniki, Greece
bDepartment of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece

Received June 23, 2011
Accepted January 20, 2012

Acenocoumarol is a vitamin K antagonist that is used for the treatment of acquired and congenital, both arterial and venous, thrombotic diseases. Its use is complicated by the narrow therapeutic range. Bleeding following oral anticoagulation, despite rare, remains the major complication. Most cases of hemorrhagic episodes usually require short hospitalization and transfusion, while surgical drainage of the hematoma is not recommended. However, in cases that conservative treatment isn’t successful, surgical intervention remains an option. We present a case of severe spontaneous bleeding of the rectus abdominis muscle which was successfully managed surgically.


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