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二尖瓣置换术后接受抗凝治疗患者的排卵后腹腔积血

Post-ovulatory Hemoperitoneum in a Patient on Anticoagulation Therapy for Mitral Valve Replacement.

作者信息

Muneeba Shaikh, Acharya Neema, Acharya Sourya, Joshi Ketav, Mohammad Shazia

机构信息

Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2023 Jan 12;15(1):e33674. doi: 10.7759/cureus.33674. eCollection 2023 Jan.

Abstract

When a patient is receiving anticoagulant therapy, the rupture of a corpus luteum cyst may go unrecognized in healthy women but becomes clinically relevant as it might exacerbate a hemoperitoneum episode. This report describes the case of a 26-year-old primipara who underwent surgical treatment for a heart defect and later experienced extensive hemoperitoneum. The patient reported to the casualty with symptoms of unstable hemodynamic status such as hypotension 90/60 mmHg and tachycardia 120 beats/minute. A multidisciplinary team decided upon surgical management after stabilizing the coagulation profile and correcting the shock with blood and blood products. The reason was discovered to be a ruptured cyst wall, which was fixed electrosurgically. The patient had a full recovery with no postoperative complications. The most noteworthy aspect of this case was the catastrophic hemoperitoneum caused by improper anticoagulant treatment monitoring. Management of such cases depends on the age of the patient, fertility, and calculating the long-term prognosis of the anticoagulation therapy for the patient.

摘要

当患者接受抗凝治疗时,黄体囊肿破裂在健康女性中可能未被察觉,但在临床上却具有相关性,因为它可能会加重腹腔内出血情况。本报告描述了一名26岁初产妇的病例,该产妇曾因心脏缺陷接受手术治疗,后来发生了广泛的腹腔内出血。患者因血流动力学不稳定症状(如低血压90/60 mmHg和心动过速120次/分钟)前往急诊。在稳定凝血状况并用血液和血液制品纠正休克后,多学科团队决定进行手术治疗。原因是发现囊肿壁破裂,通过电外科手术进行了固定。患者完全康复,无术后并发症。该病例最值得注意的方面是抗凝治疗监测不当导致的灾难性腹腔内出血。此类病例的处理取决于患者的年龄、生育能力以及计算患者抗凝治疗的长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fba7/9918852/e6aea700634c/cureus-0015-00000033674-i01.jpg

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