Abstract:

Introduction: Apixaban is a comparatively newly used oral factor Xa inhibitor, which seems to be safer, compared to both aspirin and warfarin in terms of bleeding. There are very few reported apixaban-related side effects in the literature, and one of them is rectus sheath hematoma. Case Report: A 78-year-old female patient was admitted to the emergency service of our hospital with complaints of abdominal pain, cough, and dyspnea, and she also complained of ecchymosis on her abdominal region. Her medical history revealed that she had hypertension, asthma, coronary artery disease, and nonvalvular atrial fibrillation. The patient had been on apixaban for 16 months for nonvalvular atrial fibrillation. Abdominal ultrasonography and computed tomography revealed a rectus sheath hematoma of nearly 30x40 mm in size. The patient managed conservatively, but she died due to respiratory failure. Conclusion: Clinicians should be aware of spontaneous rectus sheath hematoma in apixaban using patients with abdominal pain. Although apixaban is a safe anticoagulant drug, it may cause complications such as spontaneous bleeding.