The Drug-Induced Respiratory Disease Website

Anticoagulants, oral (vitamin K antagonists-VKA)

Rectus abdominis sheath hematoma

May prove fatal from severe blood loss

Drinnon K, Simpson SS, Puckett Y, Ronaghan CA, Richmond RE

Rectus Sheath Hematoma: A Rare Surgical Emergency.

Cureus 2020 Dec 18;12;e12156 — 2020 Dec 18 — e12156

Hatjipetrou A, Anyfantakis D, Kastanakis M

Rectus sheath hematoma: a review of the literature.

International journal of surgery (London, England) 2015 Jan;13;267-271 — 2015 Jan — 267-271

Gabel A, Müller S

Fatal hematoma during treatment with adjusted-dose subcutaneous heparin therapy.

The New England journal of medicine 1999 Jan 07;340;61-2 — 1999 Jan 07 — 61-2

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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