Abstract: Patients with liver disease are more prone to thrombosis and
bleeding events than healthy people. The decision to use anticoagulation
in patients with pulmonary embolism and liver disease requires a
cautious evaluation of the risks of bleeding and the beneﬁts of
anticoagulation. In this paper, we reported a case of a patient with
fatty liver that developed pulmonary embolism. Although the low
molecular weight heparin sodium injection was only administered at a
regular dose, the patient still developed epistaxis and hematuria. After
evaluating the efficacy and safety of different anticoagulants in
patients with pulmonary embolism and liver dysfunction, rivaroxaban is
more suitable for this patient to be treated by sequential therapy.
After three weeks of treatment with rivaroxaban, the patient’s blood
routine test results were normal, and no side effect was found. As far
as we know, this is the first reported anticoagulant therapy case for
patients with pulmonary embolism and fatty liver.