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Case Report

Rectus Sheath Hematoma Associated with Apixaban

by
Kulothungan Gunasekaran
1,*,
Amanda R. McFee Winans
2,
Swetha Murthi
3,
Mudassar Raees Ahmad
4 and
Scott Kaatz
1
1
Division of Hospital Medicine, Henry Ford Hospital, Detroit, MI, USA
2
Department of Pharmaceutical Care Services, Section of Clinical Pharmacy, Bassett Medical Center, Cooperstown, NY, USA
3
Department of Internal Medicine, Sinai Grace Hospital, Detroit, MI, USA
4
Division of Hospital Medicine, Geisinger Hospital, Danville, PA, USA
*
Author to whom correspondence should be addressed.
Clin. Pract. 2017, 7(3), 957; https://doi.org/10.4081/cp.2017.957
Submission received: 21 February 2017 / Revised: 21 February 2017 / Accepted: 19 July 2017 / Published: 1 August 2017

Abstract

Apixaban is an oral anticoagulant that directly inhibits Factor Xa and is indicated for the prophylaxis and treatment of deep venous thrombosis and stroke prevention in non-valvular atrial fibrillation. Rectus sheath hematoma is a rare, life-threatening complication of anticoagulant treatment. We describe a case of an elderly patient on apixaban for the treatment of deep venous thrombosis who developed severe abdominal pain during hospitalization. Computed tomography of the abdomen revealed left rectus sheath hematoma. Apixaban was discontinued and the patient was monitored for extension of the hematoma. After 2 days she was discharged home. Outpatient computed tomography 1 month later showed complete resolution of the rectus sheath hematoma. We recommend that clinicians become aware of the potential for rare and serious bleeding complications of anticoagulants and identify the need for early recognition and prompt management.
Keywords: rectus sheath hematoma; apixaban; anticoagulation rectus sheath hematoma; apixaban; anticoagulation

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MDPI and ACS Style

Gunasekaran, K.; McFee Winans, A.R.; Murthi, S.; Ahmad, M.R.; Kaatz, S. Rectus Sheath Hematoma Associated with Apixaban. Clin. Pract. 2017, 7, 957. https://doi.org/10.4081/cp.2017.957

AMA Style

Gunasekaran K, McFee Winans AR, Murthi S, Ahmad MR, Kaatz S. Rectus Sheath Hematoma Associated with Apixaban. Clinics and Practice. 2017; 7(3):957. https://doi.org/10.4081/cp.2017.957

Chicago/Turabian Style

Gunasekaran, Kulothungan, Amanda R. McFee Winans, Swetha Murthi, Mudassar Raees Ahmad, and Scott Kaatz. 2017. "Rectus Sheath Hematoma Associated with Apixaban" Clinics and Practice 7, no. 3: 957. https://doi.org/10.4081/cp.2017.957

APA Style

Gunasekaran, K., McFee Winans, A. R., Murthi, S., Ahmad, M. R., & Kaatz, S. (2017). Rectus Sheath Hematoma Associated with Apixaban. Clinics and Practice, 7(3), 957. https://doi.org/10.4081/cp.2017.957

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