在直接口服抗凝药治疗期间的非创伤性直肠膜血瘤
Takuto Hideyama1, Eri Watanabe1, Nobuhiro Ido1
1Neurology, Tokyo Medical University Hospital, Tokyo, JPN.
Cureus
|October 27, 2023
概括
直接口服抗凝剂 (DOACs) 可能导致直肠血瘤 (RSH),这是一个罕见的腹部并发症. 这一案例强调了RSH作为DOAC患者腹痛的差异诊断.
科学领域:
- 内部医学 内部医学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 直肠血瘤 (RSH) 是一种不常见的病症,是由直肠内出血引起的.
- 包括直接口服抗凝剂 (DOAC) 在内的抗凝剂治疗与出血并发症的风险增加有关.
- 非创伤性RSH是一种罕见的表现,特别是在接受DOAC的患者中.
研究的目的:
- 在接受直接口服抗凝剂 (DOAC) 艾皮克萨班的患者中报告一种罕见的非创伤性直肠血瘤 (RSH).
- 强调在接受DOAC治疗的患者腹痛的差异诊断中考虑RSH的重要性.
主要方法:
- 一个73岁的男性患者的病例报告,出现了突然的右腹部疼痛.
- 临床检查包括Fothergill和Carnett标志.
- 实验室检测 (血小板计数,功能,PT/INR,aPTT) 和腹部和骨盆的计算机断层扫描 (CT) 进行诊断.
- 暂时停止DOAC治疗和随访CT以确认解决方案.
主要成果:
- 患者出现了与RSH一致的急性腹痛.
- 诊断工作证实了RSH,除了稍微延长的aPTT外,凝血参数正常.
- 暂停了DOAC治疗,导致RSH解决,由随访CT证实.
- 通过暂时停止服用阿皮克萨班,患者的治疗成功.
结论:
- 直肠血瘤 (RSH) 是直接口服抗凝剂 (DOAC) 治疗的潜在并发症,尽管很少见.
- 在DOACs患者的突然腹痛和质量证明在差异诊断中需要考虑RSH.
- 这一案例强调了对与DOACs相关的出血并发症保持警的必要性.
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