Atraumatic Splenic Rupture on Direct Oral Anticoagulation

Abstract

Direct Oral Anticoagulants have become a popular go to treatment option for patients with atrial fibrillation, deep vein thrombosis, or pulmonary embolism. This case report follows a 58 year old woman who developed atraumatic splenic rupture, a rare but recognized complication of direct oral anticoagulation use.

Keywords: Apixaban; Pulmonary embolism; Splenic rupture.

Fig. 1

Enlarged spleen with active hematoma and extravasation visible as indicated by the darker areas within the spleen (red arrow). The extravasated blood can also be appreciated around the liver, seen as the dark crescent shape on the lateral border of the liver (yellow arrow).

Fig. 2

Splenic artery angiography. (A) demonstrates active extravasation as seen by the subtly darker areas indicating contrast outside the blood vessels (red arrows), suggestive of ongoing hemorrhage. (B) demonstrates post-embolization sequences where these darker patches are no longer visible.