We read with great interest the study by Semmler et al., which demonstrated that spontaneous bleeding episodes occurred in 28.6% of patients with advanced chronic liver disease and vascular live disease after direct oral anticoagulants (DOACs), and that Child-Pugh class B/C patients experienced more spontaneous bleeding episodes than Child-Pugh class A patients (36.9% versus 15.9%)(1). Notably, the authors emphasized the significance of collecting more data regarding safety of DOACs in such patients(1). Herein, we would like to further discuss this issue by reporting a Budd-Chiari syndrome (BCS) patient who developed gingival bleeding immediately after rivaroxaban.

中文翻译：

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布加综合征患者服用利伐沙班后牙龈出血的快速发展

我们饶有兴趣地阅读了 Semmler 等人的研究，该研究表明，在直接口服抗凝剂 (DOAC) 后，28.6% 的晚期慢性肝病和血管性活体疾病患者发生自发性出血事件，Child-Pugh B/ C 级患者比 Child-Pugh A 级患者经历了更多的自发性出血事件（36.9% 对 15.9%）(1)。值得注意的是，作者强调了在此类患者中收集更多有关 DOAC 安全性数据的重要性 (1)。在此，我们想通过报告一名布加综合征 (BCS) 患者在利伐沙班后立即出现牙龈出血来进一步讨论这个问题。