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血流导向栓塞术后食管黏膜下血肿,仅停用术后抗血小板治疗三天即获良好预后:一例报告

Oesophageal submucosal hematoma after flow diverter embolization with favourable outcome treated by discontinuing postoperative antiplatelet therapy for only three days: a case report.

作者信息

Takeyama Eriko, Wada Aiko, Amano Eizo, Shibuya Hiromi

机构信息

Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-Ku, Osaka-city, Osaka, 540-0006, Japan.

Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.

出版信息

JA Clin Rep. 2019 Jan 8;5(1):2. doi: 10.1186/s40981-018-0222-x.

Abstract

BACKGROUND

Oesophageal submucosal hematoma is a rare perioperative complication. When this complication develops after endovascular surgery, which requires postoperative antiplatelet therapy, whether to stop antiplatelet therapy or not is controversial. If antiplatelet therapy is discontinued, the appropriate time to resume antiplatelet therapy is unclear.

CASE PRESENTATION

A 75-year-old woman (height 134 cm, weight 37 kg) underwent flow diverter embolization for unruptured cerebral aneurysm under general anaesthesia. The patient received dual antiplatelet therapy before surgery and anticoagulation therapy intraoperatively. After surgery, the patient developed hematemesis and was diagnosed with oesophageal submucosal hematoma. Conservative treatment was initiated after discontinuing antiplatelet therapy, which was resumed 3 days after surgery. The patient showed good recovery even after the resumption of antiplatelet therapy.

CONCLUSIONS

In our case, we successfully treated oesophageal submucosal hematoma developing after endovascular surgery with early resumption of postoperative antiplatelet therapy.

摘要

背景

食管黏膜下血肿是一种罕见的围手术期并发症。当这种并发症发生在需要术后抗血小板治疗的血管内手术后时,是否停止抗血小板治疗存在争议。如果停止抗血小板治疗,恢复抗血小板治疗的合适时间尚不清楚。

病例介绍

一名75岁女性(身高134厘米,体重37千克)在全身麻醉下接受了未破裂脑动脉瘤的血流导向栓塞术。患者术前接受双联抗血小板治疗,术中接受抗凝治疗。术后,患者出现呕血,被诊断为食管黏膜下血肿。停用抗血小板治疗后开始保守治疗,并在术后3天恢复抗血小板治疗。即使恢复抗血小板治疗后,患者恢复良好。

结论

在我们的病例中,我们通过术后早期恢复抗血小板治疗成功治疗了血管内手术后发生的食管黏膜下血肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd7/6967279/77be27696d39/40981_2018_222_Fig1_HTML.jpg

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