Imanishi Naoko
   Department   University Hospital  General Thoracic Surgery, Clinical Departments
Article types journal article
Language English
Peer review Peer reviewed
Title Postoperative thoracic hemorrhage after right upper lobectomy with thoracic wall resection during rivaroxaban anticoagulant therapy for deep leg vein thrombosis: A case report.
Journal Formal name:International journal of surgery case reports
Abbreviation:Int J Surg Case Rep
ISSN code:22102612
Domestic / ForeginForegin
Volume, Issue, Page 41,340-342頁
Author and coauthor Kuwata T, Kanayama M, Hirai A, Shinohara S, Takenaka M, Oka S, Chikaishi Y, Imanishi N, Kuroda K, Tanaka F.
Publication date 2017/10
Summary Abstract
Postoperative pulmonary embolism (PE) is the one of the most important complications after thoracic surgery. This complicatin after the surgery is often treated by new anticoaglant drug, such as rivaroxaban, which dose not need to the monitoring of blood coaglation system. We experienced postoperative bleeding case during anticoaglant therapy using rivaroxaban.
The patient underwent a right upper lobectomy with lung and chest wall resection for lung cancer. On postoperative day (POD) 10, we started to use rivaroxaban to treat the deep vein thrombosis (DVT). Four days after starting the rivaroxaban treatment, severe surgical site hemorrhage occurred, which led to the need for the infusion of concentrated red cells (CRC). After stopping the rivaroxaban, the thoracic bleeding ceased. Because the event occurred so long after the surgery, and because the bleeding stopped after withdrawal of treatment, we believe that rivaroxaban induced the thoracic bleeding.
Some reports in the field of orthopedics (Turpie et al., 2009) have noted that rivarxaban is effective to prevent postoperative DVT. However, there were few reports that invied the attention to postoperative bleeding be induced by rivarxaban. Thus, we describe this case in order to alert clinicians to the potential bleeding risks associated with the admistration of rivaroxaban postoperatively.
Copyright © 2017. Published by Elsevier Ltd.