Abdominal lateral wall hematoma developed due to enoxaparin in a Covid-19 patient

Abstract

A 43-year-old male patient without any additional disease, surgery or anticoagulant use admitted to the emergency department. After evaluation with computed tomography (CT), pulmonary findings were consistent with COVID-19 pneumonia. The patient was hospitalized and enoxaparin sodium 60 mg / 0.6 ml (two subcutaneous injections per day) was initiated for prophylactic purpose. In the 16th day after admission, his hemoglobin level decreased to 7.4 g/dL. On CT scan, a right flank hematoma reaching approximately 10 cm in width, starting from the subcostal level and continuing to the inguinal canal level, was seen. Anticoagulant therapy was stopped. Erythrocyte suspension (ES), totally 10 units, were given to keep the hemoglobin level above 7 g/dL. On the 32th day after admission, the patient was discharged because his hemoglobin value, which was 10.2 g/dL at that point, had not decreased, his vital signs were stable, and his treatment for COVID-19 was completed.