UGC Aparato Digestivo, Hospital Universitario San Cecilio de Granada, España.
UGC Aparato Digestivo, Hospital Universitario Clínico San Cecilio, España.
Rev Esp Enferm Dig. 2021 Mar;113(3):232. doi: 10.17235/reed.2020.7342/2020.
The case was an 86-year-old male with multiple cardiovascular comorbidites, including anticoagulated atrial fibrillation, who underwent a colonoscopy due to acute lower gastrointestinal bleeding and anemia. Colonoscopy only showed some small angiodysplasias in the cecum. A few hours later, the patient presented with abdominal pain and hemodynamic instability. An abdominal computed tomography was performed, which showed a splenic laceration and hemoperitoneum. An expectant attitude was decided, with a good evolution from the abdominal point of view. There was no sign of active splenic bleeding in a control computed tomography. However, he developed decompensated heart failure and finally died.
患者为 86 岁男性,合并多种心血管合并症,包括抗凝治疗的心房颤动,因急性下消化道出血和贫血行结肠镜检查。结肠镜检查仅显示盲肠处有一些小的血管扩张。数小时后,患者出现腹痛和血流动力学不稳定。行腹部计算机断层扫描,显示脾裂伤和血腹。决定采取期待治疗,腹部情况良好。对照计算机断层扫描未见脾实质出血的迹象。然而,患者出现心力衰竭失代偿,最终死亡。