Atraumatic splenic rupture associated with apixaban

Basnet, Sijan; Mohanty, Elan; Mir, Izza; Dhital, Rashmi; Koirala, Ajay; Tachamo, Niranjan

doi:10.1177/2050313x19832490

Cited by 9 publications

(14 citation statements)

References 11 publications

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“…All three patients were transitioning from warfarin to rivaroxaban when they experienced a spontaneous vitreous hemorrhage [36]. Hemoperitoneum from atraumatic splenic rupture and in the setting of acute cholecystitis in patients taking DOACs has been reported [37,38].…”

Section: Epidemiologymentioning

confidence: 99%

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A Review of the Incidence Diagnosis and Treatment of Spontaneous Hemorrhage in Patients Treated with Direct Oral Anticoagulants

Gunasekaran

Rajasurya²,

Devasahayam

et al. 2020

JCM

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Anticoagulation carries a tremendous therapeutic advantage in reducing morbidity and mortality with venous thromboembolism and atrial fibrillation. For over six decades, traditional anticoagulants like low molecular weight heparin and vitamin K antagonists like warfarin have been used to achieve therapeutic anticoagulation. In the past decade, multiple new direct oral anticoagulants have emerged and been approved for clinical use. Since their introduction, direct oral anticoagulants have changed the landscape of anticoagulants. With increasing indications and use in various patients, they have become the mainstay of treatment in venous thromboembolic diseases. The safety profile of direct oral anticoagulants is better or at least similar to warfarin, but several recent reports are focusing on spontaneous hemorrhages with direct oral anticoagulants. This narrative review aims to summarize the incidence of spontaneous hemorrhage in patients treated with direct oral anticoagulants and also offers practical management strategies for clinicians when patients receiving direct oral anticoagulants present with bleeding complications.

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Section: Epidemiologymentioning

confidence: 99%

“…Bleeding complications from direct oral anticoagulant use[10,20,[22][23][24][25][26][27][30][31][32][33][34][35][37][38][39]42].…”

mentioning

confidence: 99%

A Review of the Incidence Diagnosis and Treatment of Spontaneous Hemorrhage in Patients Treated with Direct Oral Anticoagulants

Gunasekaran

Rajasurya²,

Devasahayam

et al. 2020

JCM

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show abstract

“…Direct oral anticoagulants (DOAC) are associated with spontaneous haemorrhage and, in rare cases, atraumatic solid organ rupture. 1,2 Yet, to date, no reports exist of renal rupture, or Wunderlich syndrome (WS), associated with DOAC use. To the best of our knowledge, we present the first-ever case report of WS associated with apixaban while highlighting the difficulties clinicians face in managing patients with a high-bleeding and high-thrombotic risk.…”

Section: Introductionmentioning

confidence: 99%

Life-Threatening Wunderlich Syndrome Associated with Apixaban and the Complexity of Anticoagulation Management in Bleeding Patients: A Case Report

et al. 2022

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Wunderlich syndrome is a rare and possibly life-threatening haemorrhagic syndrome presenting as spontaneous nontraumatic renal rupture with subcapsular and perinephric haemorrhage. Apixaban, a direct oral anticoagulant recommended in patients with atrial fibrillation, has previously been associated with atraumatic solid organ rupture but, to date, no case of apixaban-related Wunderlich syndrome has been reported. We report a rare case of Wunderlich syndrome associated with apixaban while addressing the difficulties face by clinicians when managing anticoagulation in bleeding patients.

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“…In the absence of a defining abdominal pain or signs of peritonitis the diagnosis can be easily missed. Atraumatic splenic rupture (ASR) is reportedly associated with apixaban 1 and dual antiplatelet therapy 2 but neither was concurrently associated in the same patient. Atrial fibrillation is independently reported 3 to be associated with spontaneous rupture of the spleen.…”

Section: Introductionmentioning

confidence: 99%

Atraumatic Splenic Rupture in a Patient on Apixaban and Dual Antiplatelet Therapy

Natarajan

Thangarasu

Ruck

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Splenic rupture due to any cause is a life-threatening complication and commonly attributed to trauma. Atraumatic splenic rupture is very rarely reported, and the incidence is currently unknown. Anticoagulants and dual anti-platelet medication can increase the chances of a splenic rupture. Surgical removal of the spleen may be warranted to prevent a life-threatening bleeding. Early identification and intervention are required for most patients as only a few qualify for medical management.

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Atraumatic splenic rupture associated with apixaban

Cited by 9 publications

References 11 publications

A Review of the Incidence Diagnosis and Treatment of Spontaneous Hemorrhage in Patients Treated with Direct Oral Anticoagulants

A Review of the Incidence Diagnosis and Treatment of Spontaneous Hemorrhage in Patients Treated with Direct Oral Anticoagulants

Life-Threatening Wunderlich Syndrome Associated with Apixaban and the Complexity of Anticoagulation Management in Bleeding Patients: A Case Report

Atraumatic Splenic Rupture in a Patient on Apixaban and Dual Antiplatelet Therapy

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