Department of Obstetrics and Gynaecology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
J Int Med Res. 2024 May;52(5):3000605241255507. doi: 10.1177/03000605241255507.
Traumatic splenic rupture is rare in pregnant women; and multiple venous thromboses of the portal vein system, inferior vena cava and ovarian vein after caesarean section and splenectomy for splenic rupture has not been previously reported. This case report describes a case of multiple venous thromboses after caesarean section and splenectomy for traumatic splenic rupture in late pregnancy. A 34-year-old G3P1 female presented with abdominal trauma at 33 weeks of gestation. After diagnosis of splenic rupture, she underwent an emergency caesarean section and splenectomy. Multiple venous thromboses developed during the recovery period. The patient eventually recovered after anticoagulation therapy with low-molecular-weight heparin and warfarin. These findings suggest that in patients that have had a caesarean section and a splenectomy, which together might further increase the risk of venous thrombosis, any abdominal pain should be thoroughly investigated and thrombosis should be ruled out, including the possibility of multiple venous thromboses. Anticoagulant therapy could be extended after the surgery.
创伤性脾破裂在孕妇中较为罕见；而剖宫产术后并发门静脉系统、下腔静脉和卵巢静脉多发静脉血栓形成，脾破裂后脾切除则尚未见报道。本病例报告描述了一例妊娠晚期创伤性脾破裂行剖宫产术后脾切除后多发静脉血栓形成的病例。一位 34 岁 G3P1 的女性在妊娠 33 周时因腹部外伤就诊。诊断为脾破裂后，她接受了紧急剖宫产和脾切除术。在恢复期间出现了多发静脉血栓形成。患者最终通过低分子量肝素和华法林抗凝治疗后康复。这些发现表明，对于已行剖宫产和脾切除术的患者，这两者可能会进一步增加静脉血栓形成的风险，任何腹痛都应进行彻底检查并排除血栓形成，包括多发静脉血栓形成的可能性。手术后抗凝治疗可以延长。
