Epidemiology
Risk Factors
- Hemodialysis (see Hemodialysis, [[Hemodialysis]])
Etiology
Coagulopathy
Acquired Vitamin K Deficiency (see Vitamin K, [[Vitamin K]])
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Anticoagulation
- General Comments: incidence is 0.6-6.6% in the setting of therapeutic anticoagulation
- Coumadin (see Coumadin, [[Coumadin]])
- Factor IIa (Thrombin) Inhibitors (see Factor IIa Inhibitors, [[Factor IIa Inhibitors]])
- Argatroban (Acova) (see Argatroban, [[Argatroban]])
- Bivalirudin (Angiomax, Angiox) (see Bivalirudin, [[Bivalirudin]])
- Dabigatran (Pradaxa) (see Dabigatran, [[Dabigatran]])
- Desirudin (Iprivask, Revasc) (see Desirudin, [[Desirudin]])
- Lepirudin (Refludan (see Lepirudin, [[Lepirudin]])
- Factor Xa Inhibitors (see Factor Xa Inhibitors, [[Factor Xa Inhibitors]])
- Apixaban (Eliquis) (see Apixaban, [[Apixaban]])
- Betrixaban
- Danaparoid (Orgaran) (see Danaparoid, [[Danaparoid]])
- Edoxaban (Lixiana) (see Edoxaban, [[Edoxaban]])
- Fondaparinux (Arixtra (see Fondaparinux, [[Fondaparinux]])
- Rivaroxaban (Xarelto) (see Rivaroxaban, [[Rivaroxaban]])
- Heparins
- Dalteparin (Fragmin) (see Dalteparin, [[Dalteparin]])
- Enoxaparin (Lovenox) (see Enoxaparin, [[Enoxaparin]])
- Heparin (Unfractionated) (see Heparin, [[Heparin]])
Antiplatelet Agents
- Non-Steroidal Anti-Inflammatory Drugs (NSAID’s) (see Non-Steroidal Anti-Inflammatory Drug, [[Non-Steroidal Anti-Inflammatory Drug]])
- Acetylsalicylic Acid (Aspirin) (see Acetylsalicylic Acid, [[Acetylsalicylic Acid]])
- Other NSAID’s
- Clopidogrel (Plavix) (see Clopidogrel, [[Clopidogrel]])
- Prasugrel (Effient) (see Prasugrel, [[Prasugrel]])
- Ticagrelor (Brilinta) (see Ticagrelor, [[Ticagrelor]])
Coagulopathic Conditions
- Antiphospholipid Antibody Syndrome (see Anti-Phospholipid Antibody Syndrome [[Anti-Phospholipid Antibody Syndrome]])
- Disseminated Intravascular Coagulation (DIC) (see Disseminated Intravascular Coagulation, [[Disseminated Intravascular Coagulation]])
- Factor IX Deficiency (Hemophilia B, Christmas Disease) (see Hemophilia B, [[Hemophilia B]])
- Factor X Deficiency (see Factor X Deficiency, [[Factor X Deficiency]])
- Von Willebrand Disease (see Von Willebrand Disease, [[Von Willebrand Disease]])
IIb/IIIa Inhibitors (see IIb IIIa Inhibitors, [[IIb IIIa Inhibitors]])
- Abciximab (ReoPro) (see Abciximab, [[Abciximab]])
- Eptifibatide (Integrilin) (see Eptifibatide, [[Eptifibatide]])
- Tirofiban (Aggrastat) (see Tirofiban, [[Tirofiban]])
Thrombocytopenia (see Thrombocytopenia, [[Thrombocytopenia]])
- Acute Leukemia Post-Chemotherapy Induction
- Immune Thrombocytopenic Purpura (ITP) (see Immune Thrombocytopenic Purpura, [[Immune Thrombocytopenic Purpura]])
- Thrombotic Thrombocytopenic Purpura (TTP) (see Thrombotic Thrombocytopenic Purpura, [[Thrombotic Thrombocytopenic Purpura]])
Thrombolytics (see Thrombolytics, [[Thrombolytics]])
- Alteplase (see Alteplase, [[Alteplase]])
Iatrogenic
- Femoral Arterial Puncture
- Cardiac Catheterization: incidence is 0.15%
- Femoral Venous Puncture
- Central Venous Catheter Placement
- Renal Biopsy
- Trans-Lumbar Aortography
Other
- Hemorrhage from Adrenal Cyst
- Rupture of Abdominal Aortic Aneurysm (AAA) (see Abdominal Aortic Aneurysm, [[Abdominal Aortic Aneurysm]])
- Rupture of Left Inferior Phrenic Artery
- Trauma
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Disgnosis
- Abdominal Ultrasound: may be diagnostic
- Abdominal/Pelvic CT without Contrast: diagnostic
Clinical Manifestations
Cardiovascular Manifestations
- Hemorrhagic Shock (see Hemorrhagic Shock, [[Hemorrhagic Shock]])
Gastrointestinal Manifestations
- Abdominal Compartment Syndrome (see Abdominal Compartment Syndrome, [[Abdominal Compartment Syndrome]]): may occur in cases with severe retroperitoneal hemorrhage
Other Manifestations
- Back Pain (see Back Pain, [[Back Pain]])
- Femoral/Lumbar Plexus Compressive Neuropathy: may present with lower extremity pain/sensory or motor findings
Treatment
- Correction of Coagulopathy: usually the mainstay of treatment for coagulopathy-related cases
- Specific Management of Femoral/Lumbar Plexus Compressive Neuropathy
- Conservative Management
- Surgical Decompression
References
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