Southern medical journal
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Warfarin is one of the most common anticoagulants in current use. It maintains a narrow therapeutic index resulting in a significant amount of bleeding. ⋯ Supratherapeutic international normalized ratios are usually best treated by holding a dose and/or reducing the weekly dose of warfarin. Patients with acute bleeding require more urgent warfarin reversal.
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Southern medical journal · Jan 2005
Review Case ReportsSurgical management of enoxaparin- and/or warfarin-induced massive retroperitoneal bleeding: report of a case and review of the literature.
A 70-year-old man on enoxaparin and warfarin sodium therapy due to pulmonary embolism was admitted for evaluation of a sudden, sharp pain in the left inguinal region. Physical examination revealed a 5 x 10 cm tender mass. Abdominal ultrasound showed a 9 x 9 x 10 cm left retroperitoneal hematoma. ⋯ A retroperitoneal abscess developed during the postoperative period which was drained percutaneously. He was discharged on postoperative day 33 with no further complaints. This case demonstrates the importance of surgical therapy in the treatment of spontaneous retroperitoneal hemorrhage caused by anticoagulant therapy.