一名新接受抗凝治疗患者的出血性胆囊炎。
Haemorrhagic cholecystitis in a newly anticoagulated patient.
作者信息
Kinnear Ned, Hennessey Derek Barry, Thomas Rebecca
机构信息
Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Department of General Surgery, Lyell McEwin Hospital, Elizabeth Vale, Australia.
出版信息
BMJ Case Rep. 2017 Apr 12;2017:bcr-2016-214617. doi: 10.1136/bcr-2016-214617.
Abstract
A 74-year-old man undergoing rehabilitation after pneumonia developed right upper quadrant abdominal pain. Five days earlier he had been commenced on apixaban for a new diagnosis of atrial fibrillation. Ultrasound and CT scans revealed an acalculous grossly thickened gallbladder, with high attenuation non-echogenic material both within and surrounding the structure. Active contrast extravasation was seen at the neck. On laparotomy, a perforated internally bleeding gallbladder containing a single calculus was found, with significant free blood within the abdomen. After cholecystectomy, the patient recovered slowly in hospital before nursing home placement.
摘要
一名74岁男性在肺炎康复期接受康复治疗时出现右上腹疼痛。五天前，他因新诊断出的心房颤动开始服用阿哌沙班。超声和CT扫描显示胆囊无结石但明显增厚，胆囊结构内及周围有高衰减无回声物质。在胆囊颈部可见造影剂外渗。剖腹手术时，发现一个穿孔且内部出血的胆囊，内有一枚结石，腹腔内有大量游离血液。胆囊切除术后，患者在医院恢复缓慢，之后被安置到疗养院。
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