A 55-year-old man with a history of atrial fibrillation, hypertension, and type 2 diabetes mellitus presented to the emergency department (ED) with abdominal pain and vomiting for 1 day after eating leftover salad. His medications included rivaroxaban, amlodipine, and metformin. Results from physical examination were unremarkable. The patient’s comprehensive metabolic panel and complete blood cell count revealed no significant abnormalities. Abdominal radiograph to rule out small bowel obstruction was within normal limits. The patient received 2 L of normal saline with resultant symptomatic improvement. The diagnosis of gastroenteritis was made with plans to discharge the patient.
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Siddiq N, Nagalla S, Choi S. Coagulation Testing in Patients Taking Direct Oral Anticoagulants: A Teachable Moment. JAMA Intern Med. Published online June 24, 2019. doi:10.1001/jamainternmed.2019.1799
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