Direct Oral Anticoagulants Haemorrhagic Event with Tubo-ovarian Abscess: A Rare Case Report

Abstract

Context: For anticoagulation therapy, direct oral anticoagulants (DOACs), such rivaroxaban, have become popular substitutes for vitamin K antagonists (VKAs). Although they have both been linked to bleeding concerns, further research is still needed to determine how safe they are in comparison and how to handle uncommon bleeding incidents. The purpose of this case study is to describe a tubo-ovarian abscess, a rare bleeding event linked to rivaroxaban, and to explore the implications for anticoagulant medication and patient management. Case Description: A 47-year-old lady who had previously been treated with rivaroxaban for atrial fibrillation presented with a tubo-ovarian abscess, a term for an inflammatory tumor affecting the fallopian tube and ovary. Severe anemia and atrial fibrillation, which was evident on an ECG with atrial tachycardia, exacerbated the condition. An ultrasound revealed that the bleeding incident was connected to a superinfected hemorrhagic ovarian cyst. Results: Blood transfusions, dual antibiotic therapy, and stopping rivaroxaban were all part of the management of this uncommon bleeding event. After receiving supportive treatment and a subsequent surgical procedure, the patient's health improved. The significance of keeping an eye out for any odd bleeding issues and modifying anticoagulant therapy accordingly is one of the case's key lessons. Conclusion: In conclusion, this example emphasizes the importance of closely monitoring anticoagulant therapy, particularly in patients with complex gynecological conditions. Effective therapeutic education and risk assessment are crucial in preventing and managing bleeding complications associated with anticoagulants. This case highlights the necessity of tailored anticoagulant management and proactive patient education to improve outcomes in similar situations.