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[肠壁内肠血肿——口服抗凝治疗的一种并发症]

[Intramural intestinal hematoma--a complication of the oral anticoagulant therapy].

作者信息

Olariu S, Farca I, Ciorogar G, Bloancă V, Dema A

机构信息

Clinica I Chirurgie, Spitalul Clinic Judeţean de Urgenţă, Universitatea Medicină si Farmacie "V. Babeş", Timişoara, România.

出版信息

Chirurgia (Bucur). 2011 Jul-Aug;106(4):551-4.

Abstract

AIM

The presentation of a rare complication of oral anticoagulant treatment involving abdominal surgery.

MATERIAL AND METHOD

A 59 years old patient who received oral anticoagulant treatment with Warfarine for repeated episodes of thrombosis of the lower limbs, suddenly develops an occlusive abdominal simptoms, which did not submit under conservative treatment. Biologically the clotting times were modified and the abdominal CT showed lesions of the first jejunal loop.

RESULTS

During surgery an amount of blood was found in abdominal cavity and a large haematoma of the first jejunal loop which required resection. The postoperative evolution was simple with discharge in the 12th day, surgically cured.

CONCLUSIONS

  1. Intramural intestinal haematoma is a rare, but possible complication of the oral anticoagulant treatment. 2. Precise diagnosis is possible, avoiding unnecessary surgical intervention because the complication is treatable using conservative therapy. 3. Surgical intervention is required in case of a sudden onset, imprecise diagnosis and unfavorable evolution which could point associated intraabdominal lesions.
摘要

目的

介绍口服抗凝治疗涉及腹部手术的一种罕见并发症。

材料与方法

一名59岁患者因下肢反复血栓形成接受华法林口服抗凝治疗,突然出现腹部梗阻症状,保守治疗无效。血液学检查显示凝血时间改变,腹部CT显示空肠第一段有病变。

结果

手术中发现腹腔内有大量血液,空肠第一段有巨大血肿,需要进行切除。术后恢复顺利,第12天出院,手术治愈。

结论

  1. 肠壁内血肿是口服抗凝治疗罕见但可能出现的并发症。2. 可以进行精确诊断,避免不必要的手术干预,因为该并发症可采用保守治疗。3. 如果突然发病、诊断不明确且病情发展不利,提示可能存在腹腔内相关病变,则需要进行手术干预。

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