Anticoagulation status post radiofrequency ablation in a patient with hepatocellular carcinoma and delayed bleeding event

Restarting anticoagulation is a tricky component of patient care. This is a case of a 65-year-old female presenting with hepatocellular carcinoma. A nonocclusive thrombus in the main portal vein was also identified. Six days postradiofrequency ablation (RFA), the patient's hemoglobin dropped to...

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Bibliographic Details
Main Authors: Oladapo Adaramola, MD, Nadia Solomon, MD, Fortune Anyanwu, BS, Abelard Desrosier, BS, Mathew Smith, MD
Format: Article
Language:English
Published: Elsevier 2020-08-01
Series:Radiology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043320302429
Description
Summary:Restarting anticoagulation is a tricky component of patient care. This is a case of a 65-year-old female presenting with hepatocellular carcinoma. A nonocclusive thrombus in the main portal vein was also identified. Six days postradiofrequency ablation (RFA), the patient's hemoglobin dropped to critical values and noncontrast computed tomography of the abdomen/pelvis revealed high density free fluid consistent with a bleed. The patient was medically managed and accepted for transfer to another hospital for IR-guided TIPS procedure. Patient recovered without any other complications. In conclusion, VTE prophylaxis be routinely initiated immediately following hepatectomy in hemodynamically stable patients without signs of active bleeding and should bleeding occur halt source then restart anticoagulation immediately.
ISSN:1930-0433