Taniai Seiichi, Nagai Wataru, Shimizu Hisashi, Masuda Yutaka, Nitatori Toshiaki, Yoshino Hideaki
Division of Cardiology, Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Department of Radiology, Kyorin University School of Medicine, Tokyo,Japan.
J Cardiol Cases. 2011 Jan 13;3(2):e103-e105. doi: 10.1016/j.jccase.2010.12.003. eCollection 2011 Apr.
An 81-year-old woman on anticoagulant therapy after mechanical heart valve replacement was admitted because of acute aortic dissection. Anticoagulant therapy had to be continued with heparin even after admission. Gastrointestinal hemorrhage occurred suddenly and she developed hemorrhagic shock. Computed tomography findings suggested that the bleeding was due to rupture of a pseudoaneurysm of the pancreaticoduodenal arcade. After the site of bleeding was identified by angiography, hemorrhage was successfully controlled by embolization with coils. With the aging of the population, vascular complications of arteriosclerosis are likely to increase. This case report provides important insights that could be helpful for treating such patients.
一名81岁女性在接受机械心脏瓣膜置换术后接受抗凝治疗，因急性主动脉夹层入院。即使入院后，抗凝治疗仍需继续使用肝素。患者突然发生胃肠道出血，并发展为失血性休克。计算机断层扫描结果提示出血是由于胰十二指肠动脉弓假性动脉瘤破裂所致。通过血管造影确定出血部位后，采用弹簧圈栓塞成功控制了出血。随着人口老龄化，动脉硬化的血管并发症可能会增加。本病例报告提供了重要的见解，可能有助于治疗此类患者。
