Rectus Sheath Hematoma in Patients Undergoing Low Molecular Weight Heparin Therapy: Case Reports and Review of the Literature

Spontaneous abdominal rectus sheath hematoma (RSH) is a clinical entitiy which has previously been known but rarely seen and may have a fatal outcome. One of the factors predisposing to RSH is anticogulant therapy. The use of low molecular weight heparins (especially in the treatment of acute coronary syndromes and deep venous thrombosis) has progressively increased in the past years and has led to reports of RSH cases secondary to abdominal subcutaneous injections. We presented three cases with RSH. Two patients succumbed due to using low molecular weight heparins. RSH should be considered in the elderly, and especially in women, who rapidly develop an abdominal mass and anemia in the course of subcutaneous low molecular weight heparin therapy.