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Published on: August 8, 2025
Spontaneous bilateral haemothorax with haemopericardium secondary to rivaroxaban
Jiun-Hao Yu1,2, Hao-Hsuan Liu3, Ming-Jer Hsieh4
1Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
What Is Known And Objective:
Although the risk of major bleeding with non-vitamin K antagonist oral anticoagulant (NOAC) is low, life-threatening bleeding can occur.
Case Summary:
We report a case of an 81-year-old female with deep vein thrombosis who developed bilateral spontaneous haemothorax and haemopericardium after rivaroxaban therapy. Diagnostic thoracentesis revealed a grossly bloody pleural effusion. She was treated with factor eight inhibitor bypassing agent, but the result was not satisfactory.
What Is New And Conclusion:
To our knowledge, this is the first case report of a concomitant presentation of spontaneous bilateral haemothorax and haemopericardium due to rivaroxaban use. This case highlights the potential risk of major haemorrhagic complication of NOAC, which could be life-threatening and require emergent reversal.
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