Van Buren Stephen F, Heit John A, Panneton Jean M, Donohue John H
Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2002 Dec;77(12):1361-3. doi: 10.4065/77.12.1361.
Vascular complications after inguinal hernia repair have been well documented. To our knowledge, all previously reported cases have been due to direct injury or compression of the vessels during the repair. We present the first case of thrombosis of the left common iliac artery after inguinal herniorrhaphy that was not due to direct injury or compression of the artery. Special coagulation testing revealed that the patient was a heterozygous carrier of the factor V R506Q (Leiden) mutation. This mutation is the most common cause of familial thrombophilia (hypercoagulable disorder) and is a known risk factor for venous thromboembolism. However, the association of this mutation with arterial thrombosis is less certain. Patients with thrombosis of the iliofemoral artery or vein after inguinal herniorrhaphy should be considered for special coagulation testing because of potentially important differences in anticoagulant treatment of the affected patient and for genetic counseling of potentially affected family members.
腹股沟疝修补术后的血管并发症已有充分记载。据我们所知，先前报道的所有病例均因修补过程中血管受到直接损伤或压迫所致。我们报告首例腹股沟疝修补术后左髂总动脉血栓形成病例，其并非由动脉直接损伤或压迫引起。特殊凝血检测显示该患者为因子V R506Q（莱顿）突变的杂合子携带者。此突变是家族性血栓形成倾向（高凝性疾病）的最常见原因，也是已知的静脉血栓栓塞危险因素。然而，该突变与动脉血栓形成的关联尚不确定。腹股沟疝修补术后发生髂股动脉或静脉血栓形成的患者，应考虑进行特殊凝血检测，这是因为对受影响患者的抗凝治疗可能存在重要差异，且可为潜在受影响的家庭成员提供遗传咨询。
