Apixaban-induced haematoma causing small bowel intussusception.
Publication Title
BMJ Case Rep
Document Type
Article
Publication Date
10-25-2019
Keywords
Aged; Atrial Fibrillation; Diagnosis, Differential; Female; Hematoma; Humans; Ileal Diseases; Intestine, Small; Intussusception; Pyrazoles; Pyridones; gastrointestinal system; general surgery; haematology (drugs and medicines)
Abstract
Apixaban (Eliquis) is a direct acting oral anticoagulant (DOAC) indicated for treatment of deep vein thrombosis, non-valvular atrial fibrillation, pulmonary embolism and postoperative venous thromboprophylaxis following hip or knee replacement. Complications are minimal and include, but are not limited to, bleeding and intracranial haemorrhage, and haematoma formation. Our patient is a 73-year-old woman who presented with clinical and radiographic findings of small bowel obstruction. She was found to be taking apixaban for atrial fibrillation. CT scan showed small bowel intussusception. She underwent an exploratory laparotomy and resection of the small bowel intussusception with primary side-to-side anastomosis. Histopathological examination showed that the intussusception was caused by an intramural haematoma. This case presents a rare instance of adult intussusception caused by a DOAC. To our knowledge, no case of intussusception caused by apixaban has yet been found in literature.
Area of Special Interest
Digestive Health
Specialty/Research Institute
Gastroenterology
Specialty/Research Institute
Surgery
