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Extensive postoperative ecchymosis in a patient taking dabigatran
Corey A Wagner1, Navpriya Oberoi, Prabhat K Ahluwalia
1Department of Obstetrics and Gynecology, St. Elizabeth Medical Center, Utica, New York 13413, USA. coreywag@yahoo.com
Journal of Minimally Invasive Gynecology
|January 15, 2013
Summary
A patient experienced severe bruising and anemia after stopping dabigatran etexilate mesylate before surgery. This case highlights potential risks of anticoagulant use and surgical outcomes.
Area of Science:
- Gynecology
- Hematology
- Pharmacology
Background:
- A 71-year-old woman with atrial fibrillation was prescribed dabigatran etexilate mesylate for anticoagulation.
- The patient underwent a total laparoscopic hysterectomy with pelvic and periaortic lymph node sampling for uterine endometrioid adenocarcinoma.
Observation:
- She discontinued dabigatran etexilate mesylate two days prior to the surgical procedure.
- The surgery itself was uneventful, with no intraoperative complications noted.
Findings:
- Postoperatively, the patient developed a severe ecchymotic reaction, characterized by widespread bruising.
- Significant edema and anemia were also observed following the procedure.
Implications:
- This case underscores the potential for severe postoperative bleeding complications even after appropriate discontinuation of anticoagulants.
- It highlights the importance of vigilant monitoring for hemorrhagic complications in patients on anticoagulation therapy undergoing gynecologic surgery.
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