Case Report: Spontaneous Intramural Hematoma of the Colon Secondary to Low Molecular Weight Heparin Therapy.
Case Report: Spontaneous Intramural Hematoma of the Colon Secondary to Low Molecular Weight Heparin Therapy.
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病例报告：低分子肝素治疗继发的结肠自发性壁内血肿
DOI：
10.3389/fphar.2021.598661
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发表时间：
2021
影响因子：
5.6
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Zhu Y;Wang C;Xu C;Liu J
背景：结肠血肿是一种罕见的出血性并发症，影响接受低分子量肝素（LMWH）治疗的患者。只有少数病例报告结肠血肿，通常发生在儿童或接受华法林治疗的患者中。病例总结：2018年3月21日，一名76岁的中国男子被诊断出患有房颤和心力衰竭，心功能NYHA III级。该患者接受LMWH抗凝治疗，并在住院第三天发生结肠血肿。腹部计算机断层扫描（CT）显示结肠区域增厚，厚度达110 mm × 78 mm，这是结肠血肿的症状。患者成功接受保守治疗。3月27日，患者腹痛缓解，CT检查显示肠内血肿吸收。结论：低分子肝素抗凝治疗最常见的轻微出血事件是出血和皮下血肿。该病例表明，肠血肿尽管发生率较低，但应被视为LMWH治疗的ADR，尤其是在出现胃肠道症状的患者中。
Background: Hematoma of the colon is a rare hemorrhagic complication that affects patients accepting low molecular weight heparin (LMWH) therapy. Only scarce cases of colon hematoma have been reported, usually in children or patients accepting warfarin therapy. Case summary: A 76-year-old Chinese man was diagnosed with atrial fibrillation and heart failure, with cardiac function NYHA grade III on March 21, 2018. This patient was given LMWH for anticoagulation therapy and developed a colon hematoma on the third day of hospitalization. Abdominal computed tomography (CT) showed the thickening of areas of the colon up to 110 mm × 78 mm in thickness, which was a symptom of colon hematoma. The patient underwent conservative treatment successfully. On March 27, the patient’s abdominal pain was alleviated, and a CT scan showed that the intestinal hematoma was absorbed. Conclusions: The most frequent minor bleeding events of LMWH anticoagulation are hemorrhage and subcutaneous hematoma. This case demonstrated that bowel hematoma despite its low incidence should be considered as an ADR of LMWH therapy, especially among patients who present with gastrointestinal symptoms.
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