Intra-abdominal bleeding as a rare complication after colonic endoscopic mucosal resection in a patient taking direct oral anticoagulants
Intra-abdominal bleeding as a rare complication after colonic endoscopic mucosal resection in a patient taking direct oral anticoagulants
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直接服用口服抗凝剂的患者进行结肠内镜粘膜切除术后腹内出血是一种罕见的并发症
DOI：
10.1007/s12328-020-01181-w
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发表时间：
2020
影响因子：
1
通讯作者：
Itoh Fumio
中科院分区：
文献类型：
--
作者：
Sato Yoshinori;Satta Yusuke;Yasuda Hiroshi;Kiyokawa Hirofumi;Yamashita Masaki;Matsuo Yasumasa;Itoh Fumio
我们描述了一例84岁女性患者的病例，该患者服用利伐沙班30 mg/天，有房颤病史。她接受内镜粘膜切除术的5毫米腺瘤位于肝曲的横结肠。手术后，患者出现逐渐加剧的腹痛，粪便中出现少量血液。因此，她在内镜粘膜切除术后第5天来我院就诊。访视时，对比增强腹部计算机断层扫描显示无外渗或游离空气;然而，证实腹膜腔内有血性腹水。因此，患者被诊断为内镜粘膜切除术后腹腔内出血，并于当天住院。入院后，停用利伐沙班并监测患者状况。由于随后的腹部计算机断层扫描显示血性腹水没有明显增加，因此没有进行介入放射学或外科手术，患者仅在提供保守治疗后出院。虽然出血和穿孔是结肠内镜黏膜切除术后的主要并发症，但到目前为止，关于内镜黏膜切除术后发生腹腔内出血的报道很少。腹腔内出血患者有时需要紧急治疗。重要的是要记住，这种并发症虽然非常罕见，但也可能发生，特别是在服用抗凝剂的患者中。
We describe the case of an 84-year old female who was taking rivaroxaban 30 mg/day and had a medical history of atrial fibrillation. She underwent endoscopic mucosal resection of a 5-mm adenoma located in the hepatic flexure of the transverse colon. Following the procedure, she developed gradually intensifying abdominal pain, with the appearance of small amount of blood in the feces. For that reason, she visited our facility on the 5th day post-endoscopic mucosal resection. At the time of the visit, contrast-enhanced abdominal computed tomography revealed no extravasation or free air; however, bloody ascites was confirmed in the peritoneal cavity. Thus, the patient was diagnosed with post-endoscopic mucosal resection intra-abdominal hemorrhage and hospitalized the same day. After admission, rivaroxaban was discontinued and patient condition monitored. Because subsequent abdominal computed tomography revealed no distinct increase in bloody ascites, no interventional radiological or surgical procedure was performed, and the patient was discharged after providing only conservative treatment. While hemorrhage and perforation are the main complications after colonic endoscopic mucosal resection, so far, there have been a few reports on the occurrence of intra-abdominal hemorrhage following endoscopic mucosal resection. Emergency treatment is sometimes required in patients with intra-abdominal hemorrhage. It is important to keep in mind that this complication, although very rare, may occur, particularly in patients taking anticoagulants.
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影响因子：
3.2
作者：
Singla, S.;Keller, D.;Dempsey, D.
通讯作者：
Dempsey, D.
升结肠壁内血肿导致腹腔内出血：息肉切除术后可能的并发症
影响因子：
2.2
作者：
E. Voudoukis;K. Spiridakis;K. Karmiris;G. Georgiou;N. Kontopodis;K. Konstantinidis;Konstantinos Psilakis;O. Miliadis;G. Tribonias;G. Paspatis
通讯作者：
G. Paspatis
结肠镜检查-纤维光学内窥镜方法进行结肠和息肉切除术。
DOI：
--
发表时间：
1974
期刊：
The Medical annals of the District of Columbia
影响因子：
--
作者：
Wherry Dc;H. Zehner
通讯作者：
H. Zehner
影响因子：
0.7
作者：
Khosla M;Webster L;Ahmad K;Chuang KY
通讯作者：
Chuang KY
息肉切除术后迟发性腹腔内出血一例报告
DOI：
10.1055/s-0043-108125
发表时间：
2017
期刊：
Zeitschrift für Gastroenterologie
影响因子：
--
作者：
A. Neesse;M. Grade;S. Dango;M. Ghadimi;V. Ellenrieder;S. Kunsch;A. Amanzada
通讯作者：
A. Amanzada