scholarly journals Spontaneous, Loculated, and Massive Hemothorax: An Uncommon Complication of Warfarin Therapy

Cureus ◽  
2021 ◽  
Author(s):  
Ammar Al-Obaidi ◽  
Nicholas Tuck ◽  
Daly Al-Hadeethi ◽  
Alaeldin Mohammed ◽  
Quoc Truong
Keyword(s):  
Warfarin Therapy ◽  
Massive Hemothorax ◽  
Uncommon Complication

scholarly journals Nontraumatic Massive Spontaneous Hemothorax with Concomitant Warfarin Use

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Nurettin Özgür Doğan ◽  
Gül Pamukçu Günaydın ◽  
Mustafa Tekin ◽  
Yunsur Çevik
Keyword(s):  
Warfarin Therapy ◽  
Rare Condition ◽  
Fresh Frozen Plasma ◽  
Main Complaint ◽  
Mediastinal Shift ◽  
Hemorrhagic Complications ◽  
Fresh Frozen ◽  
Massive Hemothorax ◽  
History Of ◽  
Frozen Plasma

Hemorrhagic complications due to warfarin use are frequently seen in emergency departments. However, nontraumatic massive hemothorax is an unexpected complication. We report a 59-year-old woman with warfarin overdose, who had massive hemothorax in right lung without any history of trauma. Her main complaint was significant dyspnea, which has gradually increased in three days. On her physical examination, she was tachypneic and had decreased lung sounds on her right hemithorax. She took warfarin regularly for aortic and mitral valve replacement for 18 years. Her INR level was 12.9 (0.8–1.2). Computed tomography of thorax revealed massive hemothorax with mediastinal shift. Fresh frozen plasma infusion was started immediately. Tube thoracostomy was performed for reexpansion of right lung and 2000 cc blood was drained in 5 minutes. Although hemorrhagic complications can be expected in warfarin therapy, thoracic hemorrhage related to warfarin therapy is relatively rare (3% of all hemorrhagic complications due to warfarin therapy). To our knowledge, massive hemothorax due to warfarin use is an extremely rare condition.

Lack of Agreement of Chromogenic and Glotting Assays for Factor X and Protein C in Warfarinised Plasma

1991 ◽  
Vol 65 (04) ◽  
pp. 360-363 ◽  
Author(s):  
P Han ◽  
K P Fung ◽  
U Rahdakrishnan
Keyword(s):  
Serine Proteases ◽  
Protein C ◽  
Warfarin Therapy ◽  
Intraclass Correlation ◽  
Chromogenic Substrate ◽  
Factor X ◽  
Laboratory Automation ◽  
Quantitative Results ◽  
Assay Methods

SummaryCoagulation serine proteases can be measured with either a chromogenic substrate assay or a clotting assay using deficient plasmas. It is a concern whether both assays give similar quantitative results, in particular in plasma obtained fiom patients on long term warfarin therapy. If these two assay methods were interchangeable, then the chromogenic substrate assay has the advantages of precision as well as laboratory automation. We used the intraclass correlation coefficient (r1) to assess the agreement between the two methods in measuring factor X and protein C levels in warfarinised plasma. The results indicate that the extent and pattern of agreement of the two methods for the measurement of the two variables in warfarinised plasma are poor, despite high Pearson product moment coefficients of correlation.

A Rare Case Report of Dabigatran Induced Oral Ulcers

2020 ◽  
Vol 15 (2) ◽  
pp. 160-162
Author(s):  
Ajeet Singh ◽  
Neel Prabha ◽  
Hitesh Yadav
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Warfarin Therapy ◽  
Systemic Embolism ◽  
Vein Thrombosis ◽  
Oral Ulcers ◽  
Retrosternal Pain ◽  
Novel Oral Anticoagulant ◽  
Rare Case Report ◽  
Deep Vein

Background: Dabigatran is a novel oral anticoagulant molecule which is a direct thrombin (Factor IIa) inhibitor and is used for prevention of stroke and systemic embolism. It is easy to administer as compared to warfarin therapy as it does not require routine laboratory monitoring and has fewer drug interactions. Objective: To present a rare case of oral ulcers secondary to dabigatran in a patient with deep vein thrombosis. Case report: A 68-year-old female presented with painful oral ulcers, retrosternal pain and difficulty in swallowing. She had been taking capsule Dabigatran for the prevention of systemic embolism for 2 months. She had experienced symptoms of onset taking dabigatran for 7 days. Clinical examination revealed three tender, well-defined, clean looking ulcers of various sizes present over the dorsum of the tongue. Dabigatran was withdrawn and the patient was on oral proton pump inhibitors. Patient showed remarkable improvement in oral ulcers after 2 weeks. Conclusion: Patient education and counseling should be done regarding this side effect of dabigatran and proper intake of this medicine.

scholarly journals When less is more: a daring conservative approach to postpneumonectomy oesophago-pleural fistula

2019 ◽  
Vol 30 (1) ◽  
pp. 146-148
Author(s):  
Lara Girelli ◽  
Elena Prisciandaro ◽  
Niccolò Filippi ◽  
Lorenzo Spaggiari
Keyword(s):  
Clinical Presentation ◽  
Clinical Status ◽  
High Morbidity ◽  
Conservative Approach ◽  
Chronic Fistula ◽  
Less Is More ◽  
Primary Surgery ◽  
History Of ◽  
Uncommon Complication

Abstract Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient’s good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.

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