Successful emergency surgery in a patient on dabigatran, after reversing the anticoagulation effect using Idarucizumab – A case report

Abstract

Surgeons are required to keep themselves updated on ever-increasing list of drugs that may influence the outcomes of surgeries, especially in an emergency scenario. Here, we report a case of acute abdomen, wherein the patient was on dabigatran, a 'Non-vit. K/Direct Oral Anti-Coagulant' (NOAC/DOAC). NOACs are relatively recent additions to anticoagulation care. In our patient, dabigatran was prescribed by a cardiologist to prevent the occurrence of stroke in the patient who was suffering from atrial fibrillation. In case of uncontrolled bleeding, or when an emergency surgery is needed, the effect of dabigatran can be reversed with the use of a specific monoclonal antibody -idarucizumab. Knowledge about the drug & its reversal agent, and a multi-disciplinary approach, could make it possible for us to operate on the patient, and avoid excessive bleeding during the surgery.