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The patient underwent emergency laparotomy, haemostasis and partial deroofing of the cyst. Retrospective review of CT scans suggested that the bleed had begun on presentation but was exacerbated by anticoagulation. To our knowledge, this is the first report of haemorrhagic hepatic cyst associated with acute anticoagulation. We discuss several important clinical lessons including cyst rupture as a possible cause of chest pain, the need for careful review of imaging and the choice of anticoagulation in patients with known simple hepatic cyst.<\/jats:p>","DOI":"10.1136\/bcr-2019-230243","type":"journal-article","created":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T21:07:19Z","timestamp":1568668039000},"page":"e230243","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Simple hepatic cyst rupture exacerbated by anticoagulation"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3876-7958","authenticated-orcid":false,"given":"Kin Seng","family":"Tong","sequence":"first","affiliation":[{"name":"General Surgery, Furness General Hospital, Barrow-in-Furness, Cumbria, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ridwanul","family":"Hassan","sequence":"additional","affiliation":[{"name":"General Surgery, Furness General Hospital, Barrow-in-Furness, Cumbria, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Gan","sequence":"additional","affiliation":[{"name":"General Surgery, Furness General Hospital, Barrow-in-Furness, Cumbria, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Warsi","sequence":"additional","affiliation":[{"name":"General Surgery, Furness General Hospital, Barrow-in-Furness, Cumbria, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,16]]},"reference":[{"key":"2025082700414670000_12.9.e230243.1","unstructured":"Knott L , Bonsall A . 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