Bouhaddoune Youssra, Bilal Marwa, Mahjouba Hajar, Skiker Imane, El Ouafi Noha, Bazid Zakaria
Department of Cardiology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco.
Department of Radiology, Mohamed First University, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco.
Radiol Case Rep. 2022 Apr 25;17(6):2269-2272. doi: 10.1016/j.radcr.2022.03.099. eCollection 2022 Jun.
Vitamin K antagonists (VKA) are recommended in patients with mechanical heart valves. Major bleeding events remain the most life-threatening complication of this therapy and sometimes it can occur in unusual anatomic areas. Spontaneous retroperitoneal hematoma is one of the rare complications of anticoagulation therapy, which needs to be recognized early and managed promptly. Here, we report a case of a 40-year-old woman with mechanical heart valve treated with acenocoumarol, who was admitted to the emergency department with abdominal pain and whose investigations came back in favor of a massive retroperitoneal hematoma. The patient was successfully treated through conservative management resulting in a good outcome. Clinicians should be careful when prescribing VKA and should always think of retroperitoneal bleeding in the event of abdominal pain or a sudden decrease in the hemoglobin levels of anticoagulated patients.
维生素K拮抗剂（VKA）被推荐用于患有机械心脏瓣膜的患者。严重出血事件仍然是这种治疗最危及生命的并发症，有时会发生在不寻常的解剖部位。自发性腹膜后血肿是抗凝治疗的罕见并发症之一，需要早期识别并及时处理。在此，我们报告一例40岁患有机械心脏瓣膜且接受醋硝香豆素治疗的女性患者，她因腹痛入住急诊科，检查结果支持巨大腹膜后血肿的诊断。该患者通过保守治疗成功治愈，预后良好。临床医生在开具VKA处方时应谨慎，对于抗凝患者出现腹痛或血红蛋白水平突然下降的情况，应始终考虑到腹膜后出血。
