Department of Emergency Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan.
Intensive Care Unit, Department of Internal Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan; Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Kanagawa, Japan.
J Emerg Med. 2022 May;62(5):e101-e104. doi: 10.1016/j.jemermed.2021.12.006. Epub 2022 Jan 31.
Short bowel syndrome (SBS) refers to a malabsorptive state caused by extensive resection of the intestinal tract that leads to chronic diarrhea, electrolyte disturbances, and malnutrition. Although relatively uncommon, patients with SBS can present to the emergency department with more serious complications that are potentially life-threatening. Among these complications, coagulopathy secondary to SBS is an underrecognized condition.
We present a case of severe coagulopathy secondary to vitamin K deficiency in SBS. The patient presented with unexplained coagulopathy and spontaneous bleeding in multiple organs. With a review of surgical history and detailed clinical evaluation, SBS complicated with vitamin K deficiency was diagnosed, and the patient was treated successfully. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When a patient with a history of repeated intestinal surgery presents with diarrhea, malnutrition, or electrolyte abnormalities, emergency physicians should suspect SBS. Among complications of SBS, vitamin K deficiency is a rare but serious cause of unexplained coagulopathy presenting to the emergency department. Understanding the pathophysiology of SBS facilitates early identification of complications and improves patient outcomes.
短肠综合征（SBS）是指由于广泛的肠道切除导致的吸收不良状态，导致慢性腹泻、电解质紊乱和营养不良。尽管相对少见，但 SBS 患者可能会因潜在危及生命的更严重并发症而到急诊科就诊。在这些并发症中，SBS 引起的凝血功能障碍是一种认识不足的情况。
我们报告了一例 SBS 继发于维生素 K 缺乏的严重凝血功能障碍。该患者表现为不明原因的凝血功能障碍和多个器官自发性出血。通过回顾手术史和详细的临床评估，诊断为 SBS 合并维生素 K 缺乏，并成功治疗了该患者。
为什么急诊医生应该了解这个情况？：当有反复肠道手术史的患者出现腹泻、营养不良或电解质异常时，急诊医生应怀疑 SBS。在 SBS 的并发症中，维生素 K 缺乏是一种罕见但严重的原因不明的凝血功能障碍，会导致患者到急诊科就诊。了解 SBS 的病理生理学有助于早期识别并发症并改善患者的结局。
