CT scan guided drainage in anticoagulated patients to avoid laparotomy: A case report

Abstract

Direct oral anticoagulant use has increased significantly over the last decade. Their perioperative management is always challenging for the anesthesiologist. Interventional radiology offers an interesting alternative nowadays, especially in emergencies. We report the case of a 52-year-old woman who was admitted to our department to manage a septic shock secondary to an abscessed collection in the right iliac fossa. After a multidisciplinary consultation, given that she was taking anticoagulation medications for venous mesenteric ischemia, it was decided to proceed with computed tomography scan-guided drainage of the collection, which resulted in the evacuation of over 500 cc of pus. This case report emphasizes the importance of interventional radiology and its role in avoiding surgical interventions in risky situations, especially for patients on anticoagulants, or at least to be carried out, in a second step, under better conditions.