Nawata Yoshitaka, Hamada Kouichi, Tajima Hiroko, Nishino Noriyuki, Nakazawa Toshihiro, Tobayashi Kenji, Saitoh Satoshi
Department of Gastroenterology, Southern-Tohoku Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2012 Aug;109(8):1394-400.
An 84-year-old woman with hepatitis C virus-related cirrhosis, hepatocellular carcinoma and atrial fibrillation, who presented with hematemesis, was initially treated with endoscopic variceal ligation (EVL) for an esophageal varix hemorrhage. However, computed tomography (CT) upon admission had revealed portal vein thrombosis, despite having received warfarin for existing atrial fibrillation. We subsequently initiated a 2-week treatment with danaparoid;warfarin being discontinued in order to reduce the risk of re-hemorrhage. A follow-up CT after treatment revealed complete reduction of the portal vein thrombosis. This is the first successful report of danaparoid use in the treatment of portal vein thrombosis that developed in a patient who had received warfarin.
一名84岁患有丙型肝炎病毒相关性肝硬化、肝细胞癌和心房颤动的女性,因呕血就诊,最初接受了内镜下静脉曲张套扎术(EVL)治疗食管静脉曲张出血。然而,入院时的计算机断层扫描(CT)显示尽管已因现有的心房颤动接受华法林治疗,但仍存在门静脉血栓形成。随后我们开始使用达那肝素进行为期2周的治疗;停用华法林以降低再次出血的风险。治疗后的随访CT显示门静脉血栓完全消退。这是关于达那肝素用于治疗接受华法林治疗患者发生的门静脉血栓形成的首例成功报告。