Hemoperitoneum Caused by an Omental Artery Bleeding Following Blunt Abdominal Trauma in a Patient with Anticoagulant Therapy: Report of a Case

口服抗凝血劑病患因腹部撞擊後網膜動脈出血引起之腹腔積血：一病例報告

邱信輝(Hsin-Hui Chiu) ； 曾人政(Ren-Cheng Tseng) ； 黃正強(Cheng-Chiang Huang)

《臺灣消化醫學雜誌》 27卷1期 (2010/03) Pp. 22-25

https://doi.org/10.6557/GJT.201003_27(1).0004

摘要

腹腔積血是一種可能會致命的情況，由很多種原因造成，一般分爲創傷性或非創傷性。腹部創傷可能引起大量腹腔內出血，特別在抗凝血劑使用之病患。我們報告一例74歲女性病患因心房顫動使用口服抗凝血劑，此次因腹部撞擊產生急性腹痛來就醫。追蹤之血色素由9.2 g/dl掉至6.5 g/dl。腹水抽取發現有腹腔積血，腹部電腦斷層檢查發現在脾臟外側有新鮮血塊凝集。經輸血及點滴注射後，血管攝影檢查發現一網膜動脈出血，之後以血管栓塞術成功地止血。病人順利地在住院第七天出院。

關鍵字

腹腔積血 ； 網膜動脈 ； 抗凝血劑治療

並列摘要

Hemoperitoneum is a potentially life-threatening entity associated with a wide variety of etiologies. Causes of intraperitoneal hemorrhage are usually divided into traumatic and nontraumatic. Trauma-related injury of the abdomen may result in massive bleeding into the peritoneal cavity, especially when a patient undergoes anticoagulant therapy. We report a 74 years old woman receiving anticoagulant therapy for atrial fibrillation, who presented with sudden onset of abdominal pain following blunt abdominal trauma. Hemoglobin had fallen to 6.5 g/dl. Abdominal paracentesis showed bloody ascites. Computed tomography of the abdomen showed a ”sentinel clot” sign with high attenuation clots adjacent to the spleen. Multiple blood transfusions and intravenous fluid were given. Visceral angiography demonstrated bleeding from an omental artery and subsequent embolization to this bleeding artery was successfully carried out. The patient was uneventfully discharged on the 7th hospital day.

並列關鍵字

hemoperitoneum ； omental artery ； anticoagulant therapy