{
  "abstract": "Spontaneous hemoperitoneum is a rare but potentially life-threatening complication of direct oral anticoagulant (DOAC) therapy. We report the case of a 59-year-old man receiving long-term rivaroxaban for atrial flutter, previously treated with tricuspid isthmus ablation, who was admitted for atypical chest pain and subsequently developed acute abdominal pain during observation. Contrast-enhanced computed tomography (CT) revealed spontaneous intra-abdominal hemorrhage presenting as a perigastric hematoma with hemoperitoneum, with the perigastric component measuring 96 mm × 58 mm, without active contrast extravasation or an underlying focal lesion. Throughout the admission, the patient remained hemodynamically stable, with no active contrast extravasation on CT and only a moderate decline in hemoglobin levels, from 14.8 g/dL at admission to a nadir of 12.3 g/dL, without requiring transfusion. He was managed with interruption of rivaroxaban and close clinical and biological monitoring alone, with full recovery and no invasive procedure required. A focused review of six comparable published cases of rivaroxaban-associated spontaneous intra-abdominal hemorrhage showed that most required invasive intervention for hemodynamic instability, underscoring the favorable outcome in this hemodynamically stable patient and supporting an individualized, severity-adapted approach to management. The case is notable for the combination of a sizeable perigastric hematoma, moderate hemoperitoneum, absence of active extravasation, hemodynamic stability, and successful non-invasive management. This combination appears to be rarely reported among previously published rivaroxaban-associated intra-abdominal hemorrhages, which predominantly required invasive intervention.",
  "abstract_shown": true,
  "affiliations": [
    "Emergency Medicine, Mohammed V Military Teaching Hospital, Rabat, MAR."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bouya Rachad"
    },
    {
      "affs": [
        0
      ],
      "name": "Darius Mbina Nzienghi"
    },
    {
      "affs": [
        0
      ],
      "name": "Naoufal Chouaib"
    },
    {
      "affs": [
        0
      ],
      "name": "Ahmed Belkouch"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/38c02wfx9722w.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116624",
  "fulltext_url": "https://europepmc.org/articles/PMC13684347",
  "id": "38c02wfx9722w",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909392",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Case Reports on Hematomas"
    ]
  ],
  "openalex": "W7213951112",
  "pdf_url": "https://europepmc.org/articles/PMC13684347?pdf=render",
  "pmcid": "PMC13684347",
  "pmid": "42909392",
  "published": "2026-09-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/38c02wfx9722w.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "MED:42909392",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909392"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Case Reports on Hematomas",
      "subfield": "surgery"
    }
  ],
  "title": "Spontaneous Perigastric Hematoma and Hemoperitoneum Associated With Rivaroxaban Therapy: A Case Report and Review of the Literature.",
  "title_text": "Spontaneous Perigastric Hematoma and Hemoperitoneum Associated With Rivaroxaban Therapy: A Case Report and Review of the Literature.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:14Z",
  "url": "https://research.draconitic.com/paper/38c02wfx9722w",
  "venue": "Cureus",
  "versions": []
}