Ben Ali Asma, Cherif Mohamed Ali, Mhajba Walid, Doghri Hamdi Hamdène, Hassouna Malek, Hechmi Youssef Zied El, Jerbi Zouheir, Ben Hassen Ines, Daghfous Mohamed Habib
Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Radiology Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Case Rep Gastrointest Med. 2017;2017:5424631. doi: 10.1155/2017/5424631. Epub 2017 Feb 12.
. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. . We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma. Medical treatment was sufficient and there was no need for surgery. . Gastrointestinal bleeding associated with shock in patients treated by oral anticoagulant should alert physicians to research a probable MIH. Urgent diagnosis and appropriate medical treatment can avoid surgical interventions.
肠壁血肿（MIH）是抗凝治疗罕见的并发症。很少有报道称出血性休克是其首发表现形式。我们报告两例口服抗凝剂治疗主动脉人工瓣膜和心房颤动的患者发生肠壁血肿导致休克的病例。患者因胃肠道出血伴血流动力学不稳定入住重症监护病房。复苏后，腹部CT扫描确诊显示广泛血肿。药物治疗有效，无需手术。口服抗凝剂治疗的患者出现与休克相关的胃肠道出血应提醒医生排查可能的肠壁血肿。紧急诊断和适当的药物治疗可避免手术干预。
