Enoxaparin-associated severe retroperitoneal bleeding and abdominal compartment syndrome: a report of two cases.

Abstract

To describe a complication of low-molecular-weight heparin (enoxaparin) in the setting of critically ill patients. Case report. The medical and surgical intensive care units of a tertiary care university teaching hospital. Two adult patients receiving enoxaparin developed retroperitoneal hematoma and abdominal compartment syndrome. Both patients became anuric and required high-dose intravenous fluids and vasopressors to maintain blood pressure. Discontinuation of enoxaparin, followed by exploratory laparotomy and evacuation of the hematoma. Immediate clinical improvement following evacuation of hematoma. High-risk patients receiving low-molecular-weight heparin should be identified and closely monitored to prevent serious bleeding complications.