Hemorrhagic lesions associated with anticoagulant therapy: a pictorial review
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Hemorrhagic lesions associated with anticoagulant therapy: a pictorial review Bahar Yılmaz Çankaya1 · Fatih Alper1 · Adem Karaman1 · Metin Akgün2 Accepted: 30 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Anticoagulant therapy is a treatment that can cause bleeding complications in many anatomical structures. Intracranial, intramuscular and intraabdominal bleeding are internal bleeding that can be secondary to anticoagulated therapy. The prognosis of these hemorrhages can be very good, depending on the anatomical region involved, or they can be fatal. Early recognition of especially intracranial and renal hemorrhages is important for prognosis. For diagnosis, CT and / or MRI should be evaluated according to the region. Internal bleeding should be kept in mind in cases such as sudden hemoglobin decrease or change in consciousness during anticoagulant therapy. Keywords Anticoagulant therapy · Hemorrhagic lesions · CT · MRI
Highlights • Internal bleeding may occur in many anatomical regions
due to anticoagulant therapy.
• Internal kanamaların tanısında radyolojik görüntüleme
önemlidir.
• Radiological findings vary according to the stage of
bleeding, location, and hemoglobin value of the patient.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11239-020-02305-2) contains supplementary material, which is available to authorized users. * Bahar Yılmaz Çankaya [email protected]; [email protected] Fatih Alper [email protected] Adem Karaman [email protected] Metin Akgün [email protected] 1
Department of Radiology, School of Medicine, Atatürk University, 25240 Erzurum, Turkey
Department of Pulmonary Diseases, School of Medicine, Atatürk University, 25240 Erzurum, Turkey
2
Introduction Anticoagulant therapy (AT) is a vital treatment modality in the prophylaxis and treatment of thromboembolic diseases which constitute a wide spectrum in terms of localization and clinical picture. However, AT can sometimes cause lifethreatening bleeding. High-dose and long-term use of anticoagulant drugs, renal failure, liver dysfunction, and senility are factors that increase the risk of bleeding. Sometimes a minor trauma or a cough can trigger bleeding. In the literature, the annual incidence of bleeding complications due to the use of anticoagulants (ACs) ranges from 0.8 to 3.5% [1, 2]. Bleeding usually occurs in the intracranial region, rectus muscle, gastrointestinal system, genitourinary system, spinal region, and skin. In the literature, rare hematoma sites, such as retropharyngeal [3] and esophageal [4] areas have also been reported. However, case presentations evaluating the multiple systems or the whole body are scarce. In this study, we aimed to present 15 cases with hemorrhagic lesions associated with AC use using cross-sectional radiological imaging findings between 2010 and 2019. Hemorrhagic lesions were reviewed in terms of their incidence, clinical significance, and differential diagno
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