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CT引导下抗凝患者引流术以避免剖腹手术:病例报告

CT scan guided drainage in anticoagulated patients to avoid laparotomy: A case report.

作者信息

Dehbi Safae, Mcharfi Mohamed Youssef El, Arfaoui Manal, Hamzaoui Hamza El, Ziani Hicham, Armel Bouchra, Alilou Mustapha, Harras Yahya El, Messaoud Ola, Aoufir Omar El, Mkira Omar, Bellarbi Karim, Bahou Khawla, Laroussi Younes, Bakali Youness

机构信息

Unit of Emergency Care, IBN Sina University Hospital, Rabat 10170, Morocco.

Department of Intensive Care Unit, IBN Sina University Hospital, Rabat 10170, Morocco.

出版信息

Radiol Case Rep. 2024 Oct 24;20(1):243-247. doi: 10.1016/j.radcr.2024.09.153. eCollection 2025 Jan.

Abstract

Direct oral anticoagulant use has increased significantly over the last decade. Their perioperative management is always challenging for the anesthesiologist. Interventional radiology offers an interesting alternative nowadays, especially in emergencies. We report the case of a 52-year-old woman who was admitted to our department to manage a septic shock secondary to an abscessed collection in the right iliac fossa. After a multidisciplinary consultation, given that she was taking anticoagulation medications for venous mesenteric ischemia, it was decided to proceed with computed tomography scan-guided drainage of the collection, which resulted in the evacuation of over 500 cc of pus. This case report emphasizes the importance of interventional radiology and its role in avoiding surgical interventions in risky situations, especially for patients on anticoagulants, or at least to be carried out, in a second step, under better conditions.

摘要

在过去十年中,直接口服抗凝剂的使用显著增加。其围手术期管理对麻醉医生来说始终具有挑战性。如今,介入放射学提供了一种有趣的替代方案,尤其是在紧急情况下。我们报告一例52岁女性病例,该患者因右髂窝脓肿继发感染性休克入住我科。经过多学科会诊,鉴于她因肠系膜静脉缺血正在服用抗凝药物,决定在计算机断层扫描引导下进行脓肿引流,引流排出了超过500毫升的脓液。本病例报告强调了介入放射学的重要性及其在危险情况下避免手术干预的作用,特别是对于服用抗凝剂的患者,或者至少在第二步中,在更好的条件下进行手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/874e/11539357/3aaf080aa8eb/gr1.jpg

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