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资源有限环境下胃癌患者右心腔内移动血栓的管理:一例报告

Management of a Right Heart Intracavitary Thrombus in Transit in a Patient With Gastric Cancer in a Resource-Limited Setting: A Case Report.

作者信息

Bermudez Marco, Pedraza Laura, Guevara Nehemias, Erazo Gloria, Valerio Fernando R

机构信息

Internal Medicine, St. Barnabas Hospital (SBH) Health System, Bronx, USA.

Internal Medicine, Universidad Católica de Honduras, San Pedro Sula, HND.

出版信息

Cureus. 2023 Aug 8;15(8):e43133. doi: 10.7759/cureus.43133. eCollection 2023 Aug.

Abstract

A right atrial thrombus is an unusual source of imminent massive saddle pulmonary embolism (PE) . A hypercoagulable state secondary to gastric cancer (GC) can result in deep vein thrombosis (DVT) with a resultant right-sided heart thrombus in transit. Here, we present a case of a young male patient from Honduras with DVT and multiple venous thrombi extending from the external iliac veins to the suprahepatic left vein, inferior vena cava, and right atrium of the heart, secondary to a hypercoagulable state from GC, adenocarcinoma type. We describe the approach of treating a right heart intracavitary thrombus with imminent risk for saddle PE and sudden cardiac death with thrombolysis through a central venous catheter (CVC) in a resource-limited setting.

摘要

右心房血栓是即将发生的大规模鞍状肺栓塞(PE)的罕见来源。继发于胃癌(GC)的高凝状态可导致深静脉血栓形成(DVT),进而形成正在迁移的右侧心脏血栓。在此,我们报告一例来自洪都拉斯的年轻男性患者,因GC腺癌类型导致的高凝状态继发DVT,多个静脉血栓从髂外静脉延伸至肝上左静脉、下腔静脉和心脏右心房。我们描述了在资源有限的情况下,通过中心静脉导管(CVC)对具有鞍状PE和心源性猝死紧迫风险的右心腔内血栓进行溶栓治疗的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/565d/10484470/ec2401ba8228/cureus-0015-00000043133-i01.jpg

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