{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:54:17Z","timestamp":1740174857849,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A hemothorax as the initial manifestation of bronchiectasis is extremely rare. We report a case of a sudden hemothorax due to exacerbation of clinically latent bronchiectasis under a direct oral anticoagulant.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 77-year-old woman presented with chest pain and a fever noted since the day before. She had stage G3 chronic kidney disease and received edoxaban for paroxysmal atrial fibrillation. She had no history of trauma or respiratory symptoms. A chest computed tomography revealed a mass with a surrounding opacity in the right lower lobe with a pleural effusion. Conservative treatment was chosen because of the stable vital signs and her respiratory condition. Her oxygen saturation dropped 7\u00a0h later with progressive anemia. Repeated chest computed tomography showed a worsening pulmonary opacity and pleural effusion. She underwent a right lower lobectomy successfully. The histopathological findings suggested that the preceding infection of the subpleural focal bronchiectasis caused the bleeding. In addition, a steep caliber change between the subpleural focal bronchiectasis and proximal normal branch may have caused an intraluminal pressure gradient resulting in a peripheral discharge causing a pleural rupture with a hemothorax.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The sudden hemothorax could have been the initial manifestation of bronchiectasis. Particular attention should be paid to peripherally localized bronchiectasis even if it is without any clinical symptoms, especially in patients with a comorbidity such as a susceptibility to infections and the use of direct oral anticoagulants.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-022-01536-0","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T02:02:29Z","timestamp":1663898549000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sudden hemothorax as a rare initial manifestation of bronchiectasis under a direct oral anticoagulant"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-7645","authenticated-orcid":false,"given":"Hikaru","family":"Nakayama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asuka","family":"Uebayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shota","family":"Yagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhei","family":"Iizuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiro","family":"Otsuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"issue":"Suppl 1","key":"1536_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/thoraxjnl-2018-212463","volume":"74","author":"AT Hill","year":"2019","unstructured":"Hill AT, Sullivan AL, Chalmers JD, De Soyza A, Elborn SJ, Floto AR, et al. British Thoracic Society Guideline for bronchiectasis in adults. Thorax. 2019;74(Suppl 1):1\u201369.","journal-title":"Thorax"},{"issue":"3","key":"1536_CR2","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/S2213-2600(21)00277-0","volume":"10","author":"S Aliberti","year":"2022","unstructured":"Aliberti S, Goeminne PC, O\u2019Donnell AE, Aksamit TR, Al-Jahdali H, Barker AF, et al. Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: international consensus recommendations. Lancet Respir Med. 2022;10(3):298\u2013306.","journal-title":"Lancet Respir Med"},{"issue":"21","key":"1536_CR3","doi-asserted-by":"publisher","first-page":"2333","DOI":"10.1001\/archinte.168.21.2333","volume":"168","author":"MT James","year":"2008","unstructured":"James MT, Laupland KB, Tonelli M, Manns BJ, Culleton BF, Hemmelgarn BR, et al. Risk of bloodstream infection in patients with chronic kidney disease not treated with dialysis. Arch Intern Med. 2008;168(21):2333\u20139.","journal-title":"Arch Intern Med"},{"issue":"1","key":"1536_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1053\/j.ajkd.2009.04.005","volume":"54","author":"MT James","year":"2009","unstructured":"James MT, Quan H, Tonelli M, Manns BJ, Faris P, Laupland KB, et al. CKD and risk of hospitalization and death with pneumonia. Am J Kidney Dis. 2009;54(1):24\u201332.","journal-title":"Am J Kidney Dis"},{"key":"1536_CR5","first-page":"8735036","volume":"2018","author":"M Abu Hishmeh","year":"2018","unstructured":"Abu Hishmeh M, Srivastava P, Lougheide Q, Srinivasan M, Murthy S. Massive spontaneous hemothorax as a complication of apixaban treatment. Case Rep Pulmonol. 2018;2018:8735036.","journal-title":"Case Rep Pulmonol"},{"issue":"3","key":"1536_CR6","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/crj.12327","volume":"11","author":"R Akgedik","year":"2017","unstructured":"Akgedik R, Gunaydin Z, Bektas O, Karagoz A, Ozturk H. Spontaneous hemothorax due to dabigatran use in a patient with atrial fibrillation. Clin Respir J. 2017;11(3):394\u20136.","journal-title":"Clin Respir J"},{"issue":"9","key":"1536_CR7","doi-asserted-by":"publisher","first-page":"300060521104771","DOI":"10.1177\/03000605211047712","volume":"49","author":"M Liu","year":"2021","unstructured":"Liu M, Liu W, Jiao H. Spontaneous hemothorax caused by concomitant low-dose rivaroxaban and itraconazole in a 95-year-old patient: case report and literature review. J Int Med Res. 2021;49(9):3000605211047712.","journal-title":"J Int Med Res"},{"issue":"3","key":"1536_CR8","first-page":"342","volume":"35","author":"TY Tsai","year":"2019","unstructured":"Tsai TY, Leu HB, Lo LW, Chen SA, Hsu PF. Spontaneous hemopericardium complicated with hemothorax in a patient receiving edoxaban therapy: a case report. Acta Cardiol Sin. 2019;35(3):342\u20134.","journal-title":"Acta Cardiol Sin"},{"issue":"1","key":"1536_CR9","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s40792-020-00830-z","volume":"6","author":"H Tsuchida","year":"2020","unstructured":"Tsuchida H, Fujikawa R, Nakamura H, Nakamura T. Nontraumatic warfarin-related intrapulmonary hemorrhage presenting as a lung mass. Surg Case Rep. 2020;6(1):70.","journal-title":"Surg Case Rep"},{"issue":"1","key":"1536_CR10","doi-asserted-by":"publisher","first-page":"118","DOI":"10.5606\/tgkdc.dergisi.2019.15090","volume":"27","author":"I Yildiz","year":"2019","unstructured":"Yildiz I, Aksu E, Ozmen Yildiz PO, Gurbak I. A case of rivaroxaban associated spontaneous hemothorax. Turk Gogus Kalp Damar Cerrahisi Derg. 2019;27(1):118\u201320.","journal-title":"Turk Gogus Kalp Damar Cerrahisi Derg"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01536-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-022-01536-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01536-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T02:03:45Z","timestamp":1663898625000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-022-01536-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,23]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1536"],"URL":"https:\/\/doi.org\/10.1186\/s40792-022-01536-0","relation":{},"ISSN":["2198-7793"],"issn-type":[{"type":"electronic","value":"2198-7793"}],"subject":[],"published":{"date-parts":[[2022,9,23]]},"assertion":[{"value":"29 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for the publication of the case details was obtained from our patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"175"}}