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依诺肝素注射继发腹直肌鞘血肿——1例罕见病例报告

Rectus Sheath Haematoma Secondary to Enoxaparin Injection- A Rare Case Report.

作者信息

Agarwal Sidharth, Lamani Yamanur P, Goudar Bhimanagouda V, Kalburgi Eshwar B, Bhavi Bheemappa K

机构信息

Intern, Department of General Surgery, BVVS S Nijalingappa Medical College and HSK Hospital and Research Centre, Navanagar, Bagalkot, Karnataka, India.

Associate Professor, Department of General Surgery, BVVS S Nijalingappa Medical College and HSK Hospital and Research Centre, Navanagar, Bagalkot, Karnataka, India.

出版信息

J Clin Diagn Res. 2017 Mar;11(3):PD11-PD12. doi: 10.7860/JCDR/2017/23849.9589. Epub 2017 Mar 1.

Abstract

Rectus sheath haematoma is a well-documented condition with an elusive diagnosis. It is an uncommon complication of anti-coagulation therapy, which can have a mortality of upto 25%. The patient discussed here is a 40-year-old female who was on Inj. Enoxaparin, who developed severe abdominal pain and hypovolemia after three days of treatment. Ultrasonography and CT scan showed a large rectus sheath haematoma on the right side, which was crossing the midline towards the left side. Inj. Enoxaparin was stopped and the patient was posted for surgery. In surgery, all clots were evacuated and inferior epigastric vessels were ligated. Patient recovered well following surgery. Here, this report presents forward a case of rectus sheath haematoma secondary to enoxaparin injection, its presentation and its surgical management.

摘要

腹直肌鞘血肿是一种有充分文献记载但诊断困难的病症。它是抗凝治疗的一种罕见并发症,死亡率可达25%。本文讨论的患者是一名40岁女性,正在接受依诺肝素注射治疗,治疗三天后出现严重腹痛和血容量不足。超声检查和CT扫描显示右侧有一个巨大的腹直肌鞘血肿,该血肿越过中线向左侧延伸。停用依诺肝素,并安排患者接受手术。手术中,清除了所有血块,并结扎了腹壁下血管。患者术后恢复良好。在此,本报告介绍了一例依诺肝素注射继发腹直肌鞘血肿的病例、其临床表现及其手术治疗方法。

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本文引用的文献

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Rectus sheath hematoma: three case reports.腹直肌鞘血肿:三例病例报告
J Med Case Rep. 2008 Jan 25;2:22. doi: 10.1186/1752-1947-2-22.
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Rectus sheath hematoma: diagnostic classification by CT.腹直肌鞘血肿:CT诊断分类
Abdom Imaging. 1996 Jan-Feb;21(1):62-4. doi: 10.1007/s002619900011.

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