Is Warfarin Safe in Elderly Patients? Illiopsoas Hematoma Leading to Abdominal Compartment Syndrome Caused by Warfarin

In the recent years, the increase of global life expectancy and atrial fibrillation has caused an growth in the number of elderly patients under anticoagulant therapy. The use of warfarin in elderly individuals is motive for concern because of the high risk of bleeding. Bleeding consequences can cause death. In addition, the patients with higher risk of bleeding are those that will benefit the most from anticoagulant therapy. We report a case of illiopsoas hematoma that caused an abdominal compartment syndrome and finally death. We report a 83-year-old male who was under anticoagulant therapy and suffered from bleeding causing an illiopsoas hematoma that eventually produced an abdominal compartment syndrome. He underwent surgery because of abdominal compartment syndrome but , finally, passed away because of pulmonary and renal complications. The use of anticoagulant in elderly can lead to death. A careful monitoring of dose is mandatory in order to avoid fatal consequences. For this purpose, different scores have been reported to help the physician to estimate benefits and risks. On this paper we also report a case of abdominal compartment syndrome caused by retroperitoneal hematoma. The treatment of illipsoas hematomas is based on discontinuation of anticoagulant and restoration of the circulating volume. In some occasions embolization could be required. However, retroperitoneal hematomas can cause other complications as abdominal compartment syndrome that also could need surgery. The physician must be take into account the fatal consequences of anticoagulant therapy in elderly patients. There are different scores designed to help to evaluate benefit and risk of bleeding. Bleeding can produce retroperitoneal hematoma that can lead to death because of bleeding, abdominal compartment syndrome and other underlying circumstances

Author(s): Ana Maria Minaya-Bravo

Abstract | Full-Text | PDF

Share This Article