1998 Presentations for the Poster and Vignette Sessions
| Intro | Prev | Next | Last |
AN UNUSUAL ABDOMINAL MASS. N.M. Guda, M. Gennis. Department of Medicine, Univ. Of Wisconsin Medical School Milwaukee Clinical campus at Sinai Samaritan Medical Center, Milwaukee, WI.
Learning Objective: Low molecular weight heparins are being used widely in clinical practice. Though they are considered safe, sometimes they can cause injection site hematomas.
Case: An 87 year old male, a nursing home resident was admitted to the hospital with a two day history of nausea, vomiting and fever. Cured of carcinoma of colon, he also has Paget's disease of the bone. Three weeks prior to this hospitalization he was treated with Enoxaparin 60mg SQ BID for suspected deep vein thrombosis of the left leg. His medications included 81mg of aspirin and he was not on any other NSAIDs. Physical exam: abdominal mass about 8cmx6cms, in the epigastrium. Laboratory Data: WBC 32,500 with no left shift, hemoglobin 6.3mg/dl, hematocrit 20, platelets 149,000. Alk.phos 469 IU/ml. Calcium 8.2mg/dl, albumin 3.2 g/dl. Bilirubin was normal. PT was 12.9 secs and PTT was 38.3 secs (nl. 1933). A CT scan of the abdomen showed two abdominal masses in the rectus abdominis muscle, measuring 6cms and 2cms in diameter. These were solid with an inhomogenous attenuation, suggestive of a neoplasm. However, a trucut biopsy specimen confirmed the diagnosis of a hematoma.
Discussion: Hematologic complications with low molecular weight heparins are not uncommon. Injection site hematomas have been reported with the use of low molecular weight heparins. Cases of spinal hematomas following spinal anesthesia in patients earlier treated with low molecular weight heparins have been reported. The FDA has recently issued a public health advisor regarding the same. While safe, low molecular weight heparins should be used with caution especially when given along with antiplatelet drugs as they can cause injection site hematomas.
| Intro | Prev | Next | Last |
What's New
- Governor's Newsletter - May 2013
- Register Now! 2013 Wisconsin Chapter Meeting
Sept. 6-7, 2013 - A Report from Wisconsin’s Internal Medicine Physician Specialists:
How Will the Medicaid Expansion Benefit Wisconsin? - Read About Our Governor Elect
- Member Accomplishments
- ACP Internist Weekly
Become a fan of the ACP Wisconsin Chapter Facebook page!
Contact Information
Steve Pearson, MD, FACP
Chapter Governor
Mark K Belknap, MD FACP
Chapter Governor-elect
Jenni Kilpatrick
Chapter Executive
Ph: 414-755-6281
E-mail: jenni@svinicki.com
