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

Radiology Case Reports. 2020;15(8):1381-1385

 

Journal Homepage

Journal Title: Radiology Case Reports

ISSN: 1930-0433 (Online)

Publisher: Elsevier

Society/Institution: University of Washington

LCC Subject Category: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine

Country of publisher: United States

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS


Oladapo Adaramola, MD (Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY, USA; Queens Hospital Center, Jamaica, NY, USA; Corresponding author.)

Nadia Solomon, MD (Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Department of Internal Medicine, New York, NY, USA)

Fortune Anyanwu, BS (Sophie Davis CUNY, New York, NY, USA)

Abelard Desrosier, BS (Sophie Davis CUNY, New York, NY, USA)

Mathew Smith, MD (Queens Hospital Center, Jamaica, NY, USA; Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Department of Internal Medicine, New York, NY, USA; Mount Sinai Ichan SOM, Mount Sinai, NY, USA)

EDITORIAL INFORMATION

Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 8 weeks

 

Abstract | Full Text

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.