心脏直视手术后肝脏自发性出血。
Spontaneous bleeding from liver after open heart surgery.
作者信息
Mir Najeeb H, Shah Mian T, Obeid Mahmoud Ali, Gallo Ricardo, Aliter Hashem
机构信息
Department of General Surgery, Armed Forces Hospital, Khamis Mushayt 61961, Saudi Arabia.
出版信息
Int J Surg Case Rep. 2013;4(10):803-4. doi: 10.1016/j.ijscr.2013.05.018. Epub 2013 Jul 16.
INTRODUCTION
Intra-abdominal hemorrhage after open heart surgery is very uncommon in routine clinical practice. There are case reports of having bleeding from spleen or liver after starting low molecular weight heparin (LMWH) postoperatively.
PRESENTATION OF CASE
Our patient is a 58-year-old man with mitral valve regurgitation, who underwent mitral valve repair and developed intra-abdominal hemorrhage 8h after open heart surgery. The exploratory laparotomy revealed the source of bleeding from ruptured sub-capsular liver hematoma and oozing from raw areas of the liver surface. Liver packing was done to control the bleeding.
DISCUSSION
The gastrointestinal complications after open heart surgery are rare and spontaneous bleeding from spleen has been reported. This is the first case from our hospital to have intra-abdominal hemorrhage after open heart surgery.
CONCLUSION
Spontaneous bleeding from liver is a possible complication after open heart surgery. We submit the case for the academic interest and to discuss the possible cause of hemorrhage.
引言
在常规临床实践中，心脏直视手术后腹腔内出血非常罕见。有术后开始使用低分子量肝素（LMWH）后脾脏或肝脏出血的病例报告。
病例介绍
我们的患者是一名58岁男性，患有二尖瓣反流，接受了二尖瓣修复手术，心脏直视手术后8小时发生腹腔内出血。剖腹探查发现出血源为肝包膜下血肿破裂以及肝表面创面渗血。进行了肝脏填塞以控制出血。
讨论
心脏直视手术后胃肠道并发症罕见，且有脾脏自发性出血的报道。这是我院首例心脏直视手术后发生腹腔内出血的病例。
结论
肝脏自发性出血是心脏直视手术后可能出现的并发症。我们提交此病例以供学术探讨并讨论出血的可能原因。
Zotero 插件