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Spontaneous Hematoma of the Rectus Abdominis Muscle During Treatment with Non-vitamin K Oral Anticoagulant: A Rare Clinical Occurrence and Review of the Literature

P. M. Mulendele, S. Halim, M. Njie, M. S. Boutar, A. Assklou, M. HABOUB, G. M. Benouna, A. DRIGHIL, R. HABBAL

Cardiology and Angiology: An International Journal · pp. 256–261 · Published 25 Sep 2023

10.9734/ca/2023/v12i4365

Abstract

Vitamin k antagonist anticoagulants (VKAs) and non-vitamin K oral anticoagulants (NOACs) are widely used in the treatment of non-valvular atrial fibrillation and other indications, but both classes of medications carry a risk of potentially serious bleeding. Spontaneous hematoma of the rectus abdominis muscle is a rare complication of NOAC treatment. Several risk factors, such as trauma, surgery, anticoagulation, coughing, intense rectus muscle contractions, pregnancy, etc., have been reported to cause rectus sheath hematoma. We report a case of spontaneous hematoma of the rectus abdominis muscle associated with moderate hemoperitoneum in a patient treated with NOAC for non-valvular atrial fibrillation (AF).  Abdominal ultrasound and computed tomography scan (CT scan) confirmed the diagnosis after clinical assessment. The treatment was generally conservative but in the case of a hemodynamically unstable patient; hemostatic procedures should be considered.

Spontaneous hematoma non-vitamin k oral anticoagulant hemoperitoneum

References (8)

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  2. 2 Hemorrhagic Complications of Anticoagulant Treatment [DOI]
  3. 3 Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation [DOI]
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  8. 8 Endoscopic diagnosis and conservative management of an intramural sigmoid haematoma complicating anticoagulant therapy.

Cited by 4

Non-traumatic Subcapsular Hematoma of the Liver in a Patient under Rivaroxaban: A Rare Clinical Occurrence

B. Abdalani, M. Njie, P. M. Mulendele, A. Zouad, M. HABOUB, G. M Benouna, A. DRIGHIL, R. HABBAL · Cardiology and Angiology: An International Journal · 2023

Spontaneous rectus sheath hematoma caused by vitamin K antagonists overdose: a case report and a review of the literature

I. Ben Ismail, M. Sghaier, Hakim Zeznaidi · International journal of surgery case reports · 2026

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