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创伤性肝损伤后下腔静脉血栓形成

Inferior vena caval thrombosis after traumatic liver injury.

作者信息

Kimoto T, Kohno H, Uchida M, Yamanoi A, Yamamoto A, Nagasue N, Ando S, Suemitsu K, Ohtani M

机构信息

Second Department of Surgery, Shimane Medical Univesity, Izumo, Japan.

出版信息

HPB Surg. 1998;11(2):111-6. doi: 10.1155/1998/53169.

Abstract

We report here the case of a 35-year-old man who presented with inferior vena cava thrombosis (IVCT) after blunt hepatic trauma. The IVCT was incidentally detected by computed tomography (CT) 35 days after deep parenchymal suturing and suture approximation for liver lacerations. The patient denied any symptoms of thrombophlebitis. However, he had presented with significantly elevated values of FDP-D-dimer and a modest increase in plasminogen concentration, which indicated that he had been in a hypercoagulable and hypofibrinolytic state after the operation. He had not undergone any prophylactic anticoagulant therapy because of his concomitant subarachnoid hemorrhage and huge hepatic hematoma. The patient was treated with an emercy thrombectomy. Posttraumatic IVCT is extremely rare phenomenon. We should consider IVCT in patients with a severe hepatic injury, particularly if their coagulation system change into hypercoagulable and hypofibrinolytic state. Additionally, this case made us reflect on the treatment of traumatic liver injury.

摘要

我们在此报告一例35岁男性患者,其在钝性肝外伤后出现下腔静脉血栓形成(IVCT)。该IVCT在对肝裂伤进行深部实质缝合和缝合接近术后35天通过计算机断层扫描(CT)偶然发现。患者否认有任何血栓性静脉炎症状。然而,他的FDP-D-二聚体值显著升高,纤溶酶原浓度略有增加,这表明他术后处于高凝和低纤溶状态。由于他同时患有蛛网膜下腔出血和巨大肝血肿,未接受任何预防性抗凝治疗。该患者接受了急诊血栓切除术。创伤后IVCT是极其罕见的现象。对于严重肝损伤患者,我们应考虑到IVCT,尤其是当其凝血系统转变为高凝和低纤溶状态时。此外,该病例促使我们反思创伤性肝损伤的治疗。

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