Acea Nebril B, Sánchez González F, Aguirrezabalaga González J, Crespo García C, Lago Novoa M, Blanco Freire N
Servicio de Cirugia General A, Hospital Juan Canalejo, La Coruña.
Rev Esp Enferm Dig. 1994 Jul;86(1):546-9.
The development of abdominal pain in the patient receiving anticoagulant therapy is more likely to pose a diagnostic dilemma. A group of intra-abdominal bleeding syndromes, which are extremely rare in patients with normal haemostasis, have been described in patients on anticoagulant therapy. Theses syndromes are of particular interest to surgeons because they simulate acute surgical conditions of the abdomen. We herein report the preoperative diagnosis of a spontaneous intramural hematoma of the small bowel by computed tomography. The authors conclude that CT should be used early in the diagnostic evaluation of abdominal pain and of acute abdomen in patients receiving anticoagulant therapy. Indications for the operative management of these patients include active bleeding, pneumoperitoneum, failure to improve with conservative management within 72 hours, worsening of symptoms, and uncertain diagnosis.
接受抗凝治疗的患者出现腹痛更有可能造成诊断难题。一组在正常止血功能的患者中极为罕见的腹腔内出血综合征，已在接受抗凝治疗的患者中被描述。这些综合征对外科医生特别有意义，因为它们模拟了腹部的急性外科病症。我们在此报告通过计算机断层扫描对小肠自发性壁内血肿进行的术前诊断。作者得出结论，对于接受抗凝治疗的患者，在腹痛和急腹症的诊断评估中应尽早使用CT。这些患者手术治疗的指征包括活动性出血、气腹、72小时内保守治疗无改善、症状恶化以及诊断不明确。
