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食管溃疡合并轻度甲型血友病:病例报告。

Esophageal ulcer associated with mild hemophilia A: case report.

机构信息

Department of Gastroenterology, Emergency County Hospital of Arad, Romania;

出版信息

Rom J Morphol Embryol. 2022 Jul-Sep;63(3):581-585. doi: 10.47162/RJME.63.3.14.

Abstract

In this paper, we present the case of a 68-year-old male with personal medical history of coagulopathy issues, who presented to our Emergency Room (Emergency County Hospital, Arad, Romania) with bleeding of the superior tract of the digestive system; the case was difficult to manage, thus warranting the intervention of the Department of Gastroenterology. Endoscopy was performed to localize the site of bleeding and to stop the hemorrhage. This procedure was not successful. The patient was transferred to our Intensive Care Unit where different medications, such as proton pump inhibitor, hemostatic agent and prokinetic drugs were administered. Unfortunately, our attempt to stop bleeding failed; this led us to expand our investigation. We focused on a possible hemophilia as the cause of bleeding, which was confirmed as hemophilia A through the coagulometry test after a period of three days. Patient medical history and coagulation test led us to believe that this is a very rare case of a mild hemophilia A. Finally, the correction of Factor VIII deficiency and repeated endoscopic hemostasis clip was able to stop patients bleeding and ensured a favorable clinical evolution of the patient.

摘要

在本文中,我们报告了一例 68 岁男性的病例,该患者有凝血功能障碍的个人病史,因上消化道出血而到我们的急诊室(罗马尼亚阿拉德县急诊医院)就诊;该病例难以处理,因此需要消化内科的干预。进行了内镜检查以定位出血部位并止血。但该程序未能成功。患者被转至我们的重症监护病房,在那里给予了不同的药物,如质子泵抑制剂、止血剂和促动力药物。不幸的是,我们停止出血的尝试失败了;这促使我们扩大了调查范围。我们专注于可能导致出血的血友病,经过三天的时间,通过凝血测定试验证实为血友病 A。患者的病史和凝血试验使我们相信这是一种非常罕见的轻度血友病 A。最后,通过因子 VIII 缺乏症的纠正和重复的内镜止血夹,成功地停止了患者的出血,并确保了患者的临床状况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/797d/9926146/a73b6a176510/RJME-63-3-581-fig1.jpg

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