García Mariano, Roman Rodrigo, Variego Matías, Talamonti Lionel, Chiganer Gastón, Parodi Roberto, Carlson Damián, Greca Alcides, Tanno Hugo, Pollastri Emilio
Servicio de Clínica Médica, Hospital Provincial del Centenario, Santa Fe, República Argentina.
Acta Gastroenterol Latinoam. 2006 Sep;36(3):147-51.
Hepatic cirrhosis is the leading cause of portal hypertension and is usually associated with the development ofsplacnic varices. Variceal intraabdominal rupture is a rare cause of hemoperitoneum. A case of spontaneous mesenteric vein rupture is reported.
43-year-old man with hepatic cirrhosis (Child-Pugh C stage) and previous bleeding of esophageal varices, admitted to hospital because of orthostatic hypotension episodes (positive tilt test) and abdominal distention. Laboratory: anemia, low platelet count and abnormal coagulation tests. CT scan showed abdominal fluid. Exploratory laparotomy was performed and 3 liters of blood were found into the abdominal cavity. The mesenteric vein had a ruptured variceal dilatation with intermitent jet bleeding. No organ abnormalities were found. Repair of the dilated vein was performed. The patient evolved well and was dismissed from hospital ten days after admittance.
To present a case in which a rare cause of intraabdominal bleeding, usually associated with high mortality rate, is follawed by a good clinical evolution.
肝硬化是门静脉高压的主要原因，通常与脾静脉曲张的发展有关。腹腔内静脉曲张破裂是腹腔积血的罕见原因。本文报道一例自发性肠系膜静脉破裂病例。
一名43岁男性，患有肝硬化（Child-Pugh C期），既往有食管静脉曲张出血史，因体位性低血压发作（直立倾斜试验阳性）和腹胀入院。实验室检查：贫血、血小板计数低和凝血试验异常。CT扫描显示腹腔积液。进行了剖腹探查，腹腔内发现3升血液。肠系膜静脉有一个破裂的静脉曲张扩张，伴有间歇性喷射性出血。未发现器官异常。对扩张的静脉进行了修复。患者病情进展良好，入院十天后出院。
介绍一例腹腔内出血的罕见原因，通常与高死亡率相关，但随后临床病情良好进展的病例。
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