2019年コロナウイルス病 (COVID-19) の後の穴性出血性コレシスティスは,抗凝固剤療法を受けている患者で
Rintaro Kinjo1, Masao Uemura1, Takafumi Ihashi1
1Department of Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, JPN.
Cureus
|September 5, 2025
まとめ
ヘモラジック胆炎 (HC) は希少な疾患である. この症例は,COVID-19と抗凝固薬が,緊急手術を必要とする,血臓の穴が開く危険因子であることを強調しています.
科学分野:
- 胃腸内科
- ヘパトビリアル手術
- 感染症
背景:
- 出血性胆炎 (HC) は,胆の重症な炎症である.
- 抗凝固剤治療はHCの既知の危険因子です.
- コロナウイルス病 2019 (COVID-19) は,高血圧症の新興トリガーです.
研究 の 目的:
- ヘモペリトニウムに穴が開いた 深刻なケースを報告する
- 抗凝固剤とCOVID-19の組み合わせたリスク要因を強調する.
- 適切な手術の重要性を強調する
主な方法:
- 87歳の男性患者の症例報告
- 腹痛,炎症マーカーの上昇,そして血腫の疑い
- 診断はコントラスト強化CTで 血流と血腫が確認されました
- 抗凝固治療の逆転後に実施された緊急の腹腔鏡胆小胞切除術.
主要な成果:
- 患者さんには 穴が開いた HC がありました
- ラパロスコープによる胆管切除は 治療に成功しました
- 生体病理学では,急性胆炎と死滅と穿孔が確認されました.
- 手術後の回復は問題なく13日目に退院した.
結論:
- この症例は,抗凝固剤を服用している患者において,COVID-19が重度のHCを引き起こす可能性を強調しています.
- 緊急の腹腔鏡切除手術は, 血液管内皮質を損傷した HC の生命を救える手術です.
- 早期の診断と治療は 良好な結果を得るために不可欠です
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