Non-traumatic Subcapsular Hematoma of the Liver in a Patient under Rivaroxaban: A Rare Clinical Occurrence

Abstract

Direct oral anticoagulants are used in the management and prophylaxis of venous thromboembolism (VTE) and other thrombotic diseases including non-valvular atrial fibrillation. The most serious complication of DOAC agents is bleeding, dominated by gastrointestinal hemorrhages, even if the bleeding risk is much rarer compared to VKA therapy. DOACs are sometimes linked to hepatotoxicity which can sometimes lead to severe hepatocellular insufficiency and also to non-hemorrhagic gastrointestinal disorders. We present a rare clinical entity of a spontaneous subcapsular hematoma of the liver in patient diagnosed with thrombosis of the right internal jugular vein treated with rivaroxaban, undergoing chemotherapy and hormonotherapy after surgery for breast cancer. The diagnosis was confirmed by imagery (abdominal CT scan) after clinical manifestation of an onset pain at the right hypochondrium of the abdomen. Conservative treatment was used in the patient with close follow up after hospital discharge.