A Case of Successful Management of Mesenteric Ischemia in a Patient with Severe Coagulopathy Caused by Dabigatran

Abstract

A 73–year–old woman was admitted to our hospital complaining of acute abdominal pain. We diagnosed her as having extensive mesenteric ischemia and extreme coagulopathy induced by the oral dabigatran she was taking. Enterectomy and Hartmann procedure were performed as emergency operations. Serious coagulopathy and active bleeding persisted for two days after the surgery. Finally, the bleeding stopped, and the patient was discharged from our hospital on hospital day 45. Blood concentrations of dabigatran may increase significantly in some patients, for a variety of reasons, and these patients are at a high risk for developing hemorrhagic complications. Such patients may be treated with antagonists or by blood purification therapy. Doctors dealing with abdominal emergencies need to be aware of the adverse effects of dabigatran.