# Tranexamic Acid Ameliorated Bleeding Tendency in Abdominal Aortic Aneurysm-Induced Chronic Disseminated Intravascular Coagulation

## TL;DR

An 84-year-old man with an abdominal aortic aneurysm showed improved bleeding after treatment with tranexamic acid, suggesting it may help manage chronic coagulation issues.

## Contribution

Demonstrates tranexamic acid as a potential treatment for chronic DIC in inoperable elderly patients with abdominal aortic aneurysms.

## Key findings

- Tranexamic acid improved hemorrhage and stabilized coagulation parameters in a patient with chronic DIC.
- Prior gastrointestinal bleeding episodes were likely due to chronic DIC rather than antiplatelet therapy.
- Antifibrinolytic therapy may be a practical option for managing chronic DIC in elderly patients.

## Abstract

An 84-year-old man with a history of cerebral infarction, inoperable abdominal aortic aneurysm (AAA), and chronic kidney disease-related anemia was admitted for rehabilitation. He had experienced recurrent gastrointestinal bleeding before admission, initially attributed to dual antiplatelet therapy. After admission, progressive subcutaneous hemorrhage developed, prompting detailed coagulation-fibrinolysis testing, which confirmed chronic disseminated intravascular coagulation (DIC) (enhanced-fibrinolytic type) secondary to AAA. Given his advanced age and overall condition, oral tranexamic acid was initiated, resulting in hemorrhage improvement and stabilization of coagulation parameters. Retrospective evaluation suggested that prior gastrointestinal bleeding episodes were more likely attributable to chronic DIC. This case highlights the importance of considering chronic DIC in patients with recurrent, unexplained bleeding, even when they have been evaluated by multiple specialists, and suggests that individualized antifibrinolytic therapy, although not standard, may serve as a practical and familiar option for general internists in carefully selected inoperable elderly patients.