Awareness of subconjunctival bleeding on warfarin therapy patient Repository

Awareness of subconjunctival bleeding on warfarin therapy patient

Diana Haryati Kusumastuti, - and Dewi Rosalina, - and Ratna Doemilah, - and Evelyn Komaratih, - (2010) Awareness of subconjunctival bleeding on warfarin therapy patient. Jurnal Oftalmologi Indonesia, 7 (4). pp. 167-170. ISSN 0126-1193

	Text (Artikel) 16. Awareness of Subconjunctival Bleeding on Warfarin Therapy.pdf Download (624kB)
	Text (Peer Review) Awareness of.pdf Download (1MB)
	Text (Similarity) Awareness of Subconjunctival Bleeding on Warfarin Therapy.pdf Download (1MB)
	Text (Laik Etik) Bukti Etik.pdf Download (396kB)

Official URL: http://journal.unair.ac.id/JOI@awareness-of-subcon...

Abstract

A case of subconjunctival bleeding as an initial sign of progressive bleeding caused by warfarin therapy on patient with mitralregurgitation, its clinical signs, multidisciplinary approach and management. A 36 years old male came to eye emergency unit with chief complaints such as subconjunctival bleeding and diplopia. He suffered from mitral regurgitation and took warfarin as oralanticoagulant during the previous month. Ophthalmology examination revealed subconjunctival bleeding and chemosis, eyelid hematoma, and proptosis on the left eye. Retinal hemorrhage (flamed shape) and vascular tortuousity were found on both eyes. Orbital CT-Scan showed retrobulbar hemorrhage on lateral side of the left orbita. Laboratory findings were International Normalized Ratio (INR) 5.36, Prothrombin Time >2.01, Activated Partial Thromboplastin Time (APTT) 124. The signs of progressive bleeding of the eye were documented. The patient was consulted to cardiology, pulmonology, and internal department. The advice given was the discontinuation of warfarin and continued with ambulatory treatment. We were aware of the progressive bleeding, and decided to hospitalize the patient. Warfarin was discontinued and vitamin K was administered intravenously. His general condition decreased, and the patient was taken to resuscitation room. Subconjunctival bleeding was the initial sign of progressive multiorgan hemorrhage causing the death of the patient 22 hours later. Massive multiorgan hemorrhage could be caused by warfarin, and subconjunctivalbleeding could be an initial sign of progressive bleeding. It is important to be aware of this sign and detailed history shouldbe taken to find underlying disease. Multidisciplinary management should be undertaken by departments such as cardiology, pulmonology, internal, and anesthesiology.

Item Type:

Article

Uncontrolled Keywords:

warfarin, subconjunctival bleeding, multi organ hemorrhage

Subjects:

R Medicine > R Medicine (General)
R Medicine > RE Ophthalmology

Divisions:

01. Fakultas Kedokteran > Ilmu Penyakit Mata

Creators: