Spontaneous Chest Wall Hematoma As A Rare Complication Of Anticoagulants And Antiaggregants
Background Anticoagulant and antiaggregant drugs (Blood thinners) are currently employed for various indications, The most significant complication associated with these medications is hemorrhage. In this study, patients who used blood thinners and developed spontaneous chest wall hematomas were evaluated.
Method Between January 2016 and December 2024, a total of 13 patients with a history of blood thinner use and spontaneous chest wall hematoma were referred to our clinic for further evaluation. The following aspects were considered in the analysis: radiological findings, demographic characteristics, primary pathologies, and treatment modalities.
Results Nine of the 13 patients without a history of major chest wall trauma, with large or progressive hematoma underwent surgical intervention, and hematoma evacuation was performed. During the surgical process, no active bleeding was detected and the hematoma, which was confined between the muscle fascia, was evacuated. The patients were discharged from hospital with full recovery. In the course of the medical treatment and follow up of four patients, two of those exhibiting an overall poor condition were unfortunately died.
Conclusion The most significant adverse effect associated with blood thinner medications is bleeding. Spontaneous chest wall hematoma is an uncommon entity. Repetitive micro-traumas that occur in patients who are mobilised or positioned with support from the axillary or pectoral region, especially in the elderly and mobility-limited patient group, lead to hemorrhage and hematoma due to the effect of anticoagulants. Surgical drainage is beneficial for appropriate patients in terms of both patient comfort and preventing infectious processes.

Keywords: Antikoagulants, Antiaggregants, Spontaneous hemorragia, Chest wall, Hematoma

Antikoagülanlar ve Antiagregantlarýn Nadir Bir Komplikasyonu Olarak Spontan Göðüs Duvarý Hematomu

Antikoagülanlar ve Antiagregantlarýn Nadir Bir Komplikasyonu Olarak Spontan Göðüs Duvarý Hematomu
Amaç: Antikoagülan ve antiagregant ilaçlar (kan sulandýrýcýlar) günümüzde çeþitli endikasyonlarla kullanýlmaktadýr. Bu ilaçlarla iliþkili en önemli komplikasyon kanamadýr. Bu çalýþmada, kan sulandýrýcý ilaçlar kullanan ve spontan göðüs duvarý hematomlarý geliþen hastalar deðerlendirilmiþtir.
Gereç ve Yöntem: Ocak 2016-Aralýk2024 arasýnda antikoagulan veya antiagregan kullaným hikayesi olan ve spontan göðüs duvarý hematomu nedeniyle kliniðimize refere edilen 13 hasta, radyolojik bulgularý; demografik özellikleri; primer patolojileri ve tedavi yöntemleri açýsýndan deðerlendirilerek sunulmuþtur.
Bulgular: Majör göðüs duvarý travma öyküsü olmayan 13 hastanýn, hematomu büyük olan veya progrese olan 9 tanesine cerrahi olarak müdahele edilerek, hematom tahliyesi yapýldý. Kas fasyalarý arasýnda sýnýrlanmýþ hematom tahliye edilirken aktif kanama odaðý saptanmadý; hastalar þifa ile taburcu edildi. Takip edilen 4 hastadan genel durumu bozuk olan 2 tanesi kaybedildi, diðer iki hastada komplikasyonsuz tam regresyon izlendi.
Sonuç: Antikogulan ilaçlarýn en önemli yan etkisini, kanama oluþturmaktadýr. Göðüs duvarýný oluþturan kaslara kanama nadir görülmektedir. Özellikle yaþlý ve hareket kýsýtlýlýðý olan hasta grubunda aksiller veya pektoral bölgeden desteklenerek mobilize edilen veya pozisyon verilen hastalarda oluþan tekrarlayan mikro travmalar antikoagulanlarýn etkisiyle hemorajiye ve hematoma yol açmaktadýr. Progrese olmayan veya boyutu küçük olan hematomlarda medikal tedavi ve takip yeterliyken; uygun hastalarda cerrahi olarak drenaj yapýlmasý hem hasta konforu açýsýndan hem de geliþebilecek enfeksiyöz süreçlerin önüne geçmek açýsýndan faydalý olacaktýr.

Anahtar Kelimeler: Antikoagulanlar, Antiaggregants, Spontan hemoraji, Göðüs duvarý, Hematom.