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Atraumatic splenic rupture associated with apixaban
Sijan Basnet1, Elan Mohanty1, Izza Mir1
1Department of Medicine, Reading Hospital and Medical Center, West Reading, PA, USA.
SAGE Open Medical Case Reports
|March 1, 2019
Summary
Apixaban, a direct oral anticoagulant, can cause rare bleeding events like atraumatic splenic rupture. This case highlights a serious adverse event in an elderly patient, emphasizing the need for vigilance.
Area of Science:
- Pharmacology
- Hematology
- Internal Medicine
Background:
- Apixaban is a direct oral anticoagulant targeting Factor Xa.
- Bleeding complications, including splenic rupture, are known risks.
- Atraumatic splenic rupture is a rare but life-threatening condition.
Observation:
- An 86-year-old male presented with severe left upper quadrant abdominal pain.
- The patient exhibited signs of hemorrhagic shock.
- Imaging revealed atraumatic splenic rupture and hemoperitoneum.
Findings:
- The patient's presentation was consistent with atraumatic splenic rupture.
- Apixaban was identified as a potential contributing factor to the bleeding event.
- Hemorrhagic shock was a critical complication.
Implications:
- This case underscores the potential for serious bleeding complications with direct oral anticoagulants.
- Clinicians should consider atraumatic splenic rupture in patients on apixaban presenting with abdominal pain and shock.
- Further research may be needed to elucidate the precise risk factors and mechanisms.
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