Acute-onset severe gastrointestinal tract hemorrhage in a postoperative patient taking rivaroxaban after total hip arthroplasty: a case report.

Journal of Medical Case Reports
Michael BolandEnda McDermott

Abstract

Rivaroxaban, a new oral anticoagulant, is currently licensed for use in patients undergoing orthopedic surgery. It is more efficacious than other anticoagulants such as low molecular weight heparin and does not require daily monitoring. It has also been shown to be efficacious in patients with venous thromboembolism and acute coronary syndrome. Although hemorrhage is a known side effect of this new anticoagulant, we could find no case reports in the literature of patients suffering severe hemorrhage whilst taking rivaroxaban. Thus, we describe the first case of potentially fatal hemorrhage in a patient taking rivaroxaban. We report the case of a 58-year-old Caucasian man with acute-onset severe per rectal bleeding who had undergone total hip arthroplasty four weeks prior to the onset of symptoms and was taking rivaroxaban in the postoperative period. Rivaroxaban was discontinued immediately but, having required nine units of packed red blood cells in a peripheral hospital due to a rapidly decreasing hemoglobin level, our patient was transferred to our tertiary referral center where he required a further eight units of packed red blood cells over a 48-hour period to manage his ongoing hemorrhage and maintain hemodynamic stabilit...Continue Reading

References

Jun 27, 2008·The New England Journal of Medicine·Bengt I ErikssonUNKNOWN RECORD1 Study Group
Jun 27, 2008·The New England Journal of Medicine·Michael R LassenUNKNOWN RECORD3 Investigators
Dec 7, 2010·The New England Journal of Medicine·Rupert BauersachsSebastian Schellong

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Citations

Oct 26, 2012·Thrombosis·Sophie TestaEmilia Cancellieri
Jun 25, 2013·Journal des maladies vasculaires·M M SamamaA Lillo-Le Louët
Nov 11, 2014·Journal of Clinical Pharmacy and Therapeutics·A Tas TunaS G Beyaz
May 9, 2015·Case Reports in Surgery·Harry Chow, Michael K Ng
Oct 3, 2012·Thrombosis Research·Meyer Michel SamamaLena Le Flem
Mar 14, 2017·Journal of Medical Case Reports·Yuliia LysanetsOlena Bieliaieva
Aug 24, 2017·European Journal of Haematology·Kathrine O F JensenHenrik Hansen

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Methods Mentioned

BETA
total hip arthroplasty

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