Ghobrial Michel W, Karim Mohammad, Mannam Sunitha
Mercy Catholic Medical Center, Department of Medicine, Mercy Fitzgerald Hospital/Mercy Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Am J Hematol. 2002 Dec;71(4):314-7. doi: 10.1002/ajh.10214.
We report the case of a 40-year-old African-American female who presented to the Emergency Department with unstable angina. The patient, who had multiple risk factors for coronary artery disease, was admitted to the coronary care unit for cardiac work-up and management. Shortly after the intravenous administration of unfractionated heparin, she suffered the acute onset of upper abdominal pain and shock. A CT scan of the abdomen revealed splenic rupture with hemoperitoneum. The patient, who was managed surgically, had complete recovery before discharge. A review of systems and medical records revealed no obvious risk factors or other potential etiology for this rupture. We herein provide the characteristics of this rarely documented causal relationship between heparin and spontaneous splenic rupture and retrospectively review similar cases in the literature.
我们报告了一例40岁非裔美国女性患者，她因不稳定型心绞痛就诊于急诊科。该患者有多种冠状动脉疾病危险因素，被收入冠心病监护病房进行心脏检查和治疗。在静脉注射普通肝素后不久，她突然出现上腹部疼痛和休克。腹部CT扫描显示脾破裂伴腹腔积血。该患者接受了手术治疗，出院前完全康复。系统回顾和病历查阅未发现此次破裂的明显危险因素或其他潜在病因。我们在此阐述这种肝素与自发性脾破裂之间鲜有记录的因果关系的特点，并回顾文献中类似病例。
