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Gallbladder hemorrhage during orally administered edoxaban therapy: a case report
Hideya Itagaki1, Suzuki Katuhiko2
1Department of General Surgery, Honjou Daiichi Hospital, 110 Iwabuchishita, Yurihonnjou, Akita, 015-8567, Japan. hideya.itagaki@gmail.com.
Journal of Medical Case Reports
|December 27, 2019
Summary
Gallbladder hemorrhage is a rare but possible complication in patients taking direct oral anticoagulants like edoxaban. This case highlights the need for awareness of this serious side effect in anticoagulant therapy.
Area of Science:
- Gastroenterology
- Hematology
- Pharmacology
Background:
- Edoxaban is an oral anticoagulant used for conditions like cerebral infarction and venous thrombosis.
- Gastrointestinal hemorrhage occurs in approximately 1% of patients on edoxaban.
- Direct oral anticoagulants (DOACs) represent a significant advancement in anticoagulant therapy.
Observation:
- An 86-year-old woman on edoxaban presented with melena and severe anemia.
- Endoscopy revealed hemobilia, and CT confirmed gallbladder fundus hemorrhage.
- The patient was treated conservatively with fluid therapy and later underwent cholecystectomy.
Findings:
- The patient experienced gallbladder hemorrhage, a rare adverse event associated with edoxaban.
- No false aneurysms or neoplastic lesions were found during pathological examination post-cholecystectomy.
- The patient recovered without further anemia progression after treatment and surgery.
Implications:
- Gallbladder hemorrhage should be considered a potential complication in patients receiving direct oral anticoagulants.
- This case underscores the importance of vigilant monitoring for unusual bleeding sites in patients on anticoagulation.
- Further research may be needed to elucidate the mechanisms and incidence of DOAC-associated gallbladder hemorrhage.
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