Spontaneous mesenteric hematoma associated to warfarin with surgical resolution
Introduction: spontaneous mesenteric hematoma is rare. It has been described as a complication of prolonged anticoagulation, more often associated with warfarin. The standard diagnostic study is computed tomography. Therapeutics of this pathology is under discussion. It is known that the conservativ...
Guardado en:
| Autores principales: | , , , , , , |
|---|---|
| Formato: | Artículo revista |
| Lenguaje: | Español |
| Publicado: |
Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2019
|
| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/23472 |
| Aporte de: |
| id |
I10-R10-article-23472 |
|---|---|
| record_format |
ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-10 |
| container_title_str |
Revistas de la UNC |
| language |
Español |
| format |
Artículo revista |
| topic |
hematoma mesentery anticoagulants warfarin surgical procedures operative. hematoma mesenterio anticoagulantes warfarina procedimientos quirúrgicos operativos |
| spellingShingle |
hematoma mesentery anticoagulants warfarin surgical procedures operative. hematoma mesenterio anticoagulantes warfarina procedimientos quirúrgicos operativos Yaryura Montero, Jose Gabriel Petersen, María Laura Cafaro, Mario Alberto Cardenas Villa, Roberto Dario Bianco, Agustín Cardozo Dutra, Blanca Garcia, Jose Sebastian Spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| topic_facet |
hematoma mesentery anticoagulants warfarin surgical procedures operative. hematoma mesenterio anticoagulantes warfarina procedimientos quirúrgicos operativos |
| author |
Yaryura Montero, Jose Gabriel Petersen, María Laura Cafaro, Mario Alberto Cardenas Villa, Roberto Dario Bianco, Agustín Cardozo Dutra, Blanca Garcia, Jose Sebastian |
| author_facet |
Yaryura Montero, Jose Gabriel Petersen, María Laura Cafaro, Mario Alberto Cardenas Villa, Roberto Dario Bianco, Agustín Cardozo Dutra, Blanca Garcia, Jose Sebastian |
| author_sort |
Yaryura Montero, Jose Gabriel |
| title |
Spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| title_short |
Spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| title_full |
Spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| title_fullStr |
Spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| title_full_unstemmed |
Spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| title_sort |
spontaneous mesenteric hematoma associated to warfarin with surgical resolution |
| description |
Introduction: spontaneous mesenteric hematoma is rare. It has been described as a complication of prolonged anticoagulation, more often associated with warfarin. The standard diagnostic study is computed tomography. Therapeutics of this pathology is under discussion. It is known that the conservative treatment is carried out in stable hemodynamically patients with spontaneous mesenteric hematoma, leaving surgical treatment as an alternative for patients in shock. Our objective is present a case of an adult patient with spontaneous mesenteric hematoma in relation to the warfarin, surgically treated with good evolution. Clinical case: Patient of 67 years, female, with spontaneous mesenteric hematoma in relation to warfarin, with a history of replacement of the mitral biological valve with tricuspid plastic of more than 3 months, in daily controls due to mishandling of coagulation with oral anticoagulant; she consult for sudden abdominal pain, in the epigastric region, accompanied by gastric vomiting. Physical examination she presented abdominal defense and peritoneal reaction. Computed tomography of the abdomen and pelvis was requested, where mesenteric hematoma is reported. Because the patient presented signs of peritoneal irritation, emergency surgery was performed with segmental resection of the small intestine; with good postoperative evolution, being discharged on the fifth day. Pathological anatomy reports massive submucosal hemorrhage. Conclusion: in a patient with abdominal pain with signs of peritoneal irritation, alteration of International Normalized Ratio due to the use of warfarin, without a traumatic history, a spontaneous mesenteric hematoma should be suspected and surgical treatment should be considered. |
| publisher |
Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2019 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/23472 |
| work_keys_str_mv |
AT yaryuramonterojosegabriel spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT petersenmarialaura spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT cafaromarioalberto spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT cardenasvillarobertodario spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT biancoagustin spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT cardozodutrablanca spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT garciajosesebastian spontaneousmesenterichematomaassociatedtowarfarinwithsurgicalresolution AT yaryuramonterojosegabriel hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT petersenmarialaura hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT cafaromarioalberto hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT cardenasvillarobertodario hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT biancoagustin hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT cardozodutrablanca hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT garciajosesebastian hematomamesentericoespontaneoasociadoawarfarinaconresolucionquirurgica AT yaryuramonterojosegabriel hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica AT petersenmarialaura hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica AT cafaromarioalberto hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica AT cardenasvillarobertodario hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica AT biancoagustin hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica AT cardozodutrablanca hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica AT garciajosesebastian hematomamesentericoespontaneoassociadoavarfarinacomresolucaocirurgica |
| first_indexed |
2022-08-20T01:26:19Z |
| last_indexed |
2022-08-20T01:26:19Z |
| _version_ |
1770718985950593024 |
| spelling |
I10-R10-article-234722020-02-26T20:16:45Z Spontaneous mesenteric hematoma associated to warfarin with surgical resolution Hematoma mesentérico espontáneo asociado a warfarina con resolución quirúrgica Hematoma mesentérico espontâneo associado à varfarina com resolução cirúrgica Yaryura Montero, Jose Gabriel Petersen, María Laura Cafaro, Mario Alberto Cardenas Villa, Roberto Dario Bianco, Agustín Cardozo Dutra, Blanca Garcia, Jose Sebastian hematoma mesentery anticoagulants warfarin surgical procedures operative. hematoma mesenterio anticoagulantes warfarina procedimientos quirúrgicos operativos Introduction: spontaneous mesenteric hematoma is rare. It has been described as a complication of prolonged anticoagulation, more often associated with warfarin. The standard diagnostic study is computed tomography. Therapeutics of this pathology is under discussion. It is known that the conservative treatment is carried out in stable hemodynamically patients with spontaneous mesenteric hematoma, leaving surgical treatment as an alternative for patients in shock. Our objective is present a case of an adult patient with spontaneous mesenteric hematoma in relation to the warfarin, surgically treated with good evolution. Clinical case: Patient of 67 years, female, with spontaneous mesenteric hematoma in relation to warfarin, with a history of replacement of the mitral biological valve with tricuspid plastic of more than 3 months, in daily controls due to mishandling of coagulation with oral anticoagulant; she consult for sudden abdominal pain, in the epigastric region, accompanied by gastric vomiting. Physical examination she presented abdominal defense and peritoneal reaction. Computed tomography of the abdomen and pelvis was requested, where mesenteric hematoma is reported. Because the patient presented signs of peritoneal irritation, emergency surgery was performed with segmental resection of the small intestine; with good postoperative evolution, being discharged on the fifth day. Pathological anatomy reports massive submucosal hemorrhage. Conclusion: in a patient with abdominal pain with signs of peritoneal irritation, alteration of International Normalized Ratio due to the use of warfarin, without a traumatic history, a spontaneous mesenteric hematoma should be suspected and surgical treatment should be considered. Introducción: El hematoma mesentérico espontaneo es poco frecuente. Se ha informado como complicación de anticoagulación prolongada, asociado con mayor frecuencia a la warfarina. El estudio diagnostico estándar es la tomografía computada. La terapéutica de esta patología, está en discusión. Se sabe que en pacientes hemodinámicamente estables con hematoma mesentérico espontaneo se lleva a cabo una conducta conservadora, dejando el tratamiento quirúrgico como alternativa para pacientes en shock. Nuestro objetivo es reportar el caso de una paciente adulta con hematoma mesentérico espontáneo en relación a warfarina, tratado de manera quirúrgica con buena evolución. Caso clínico: Paciente de 67 años, sexo femenino, con hematoma mesentérico espontáneo en relación a warfarina, con antecedente de reemplazo de válvula biológica mitral con plástica tricúspidea de más de 3 meses, en controles diarios por mal manejo de la coagulación con anticoagulante oral; consulto por dolor abdominal súbito, en región epigástrica, acompañado de vómitos gástricos. Al examen físico se objetivo defensa y reacción peritoneal. Se solicitó tomografía computada abdomen y pelvis donde se informó hematoma mesentérico. Debido a que la paciente presentaba signos de irritación peritoneal se realizó cirugía de urgencia con resección segmentaria de intestino delgado. Con buena evolución postquirúrgica, siendo dada de alta al quinto día. Anatomía patológica informa hemorragia masiva submucosa. Conclusión: Ante un paciente que presenta dolor abdominal con signos de irritación peritoneal, alteración de la Relación Internacional Normatizada por consumo de warfarina, sin historia traumática, debe sospecharse un hematoma mesentérico espontáneo y considerar el tratamiento quirúrgico. Introdução Hematoma espontâneo mesentérico é raro. Tem sido relatada como uma complicação da anticoagulação prolongada, mais frequentemente associada à varfarina. O estudo diagnóstico padrão é a tomografia computadorizada. A terapêutica desta patologia está em discussão. Sabe-se que em pacientes hemodinamicamente estáveis com hematoma espontâneo mesentérico é realizado um comportamento conservador, deixando o tratamento cirúrgico como uma alternativa para pacientes em choque. Nosso objetivo é relatar o caso de um paciente adulto com hematoma mesentérico espontâneo em relação à varfarina, tratado cirurgicamente com boa evolução. Caso clínico: Paciente do sexo feminino, 67 anos, portadora de hematoma mesentérico espontâneo em relação à varfarina, com história de substituição da valva mitral biológica por plástico tricúspide há mais de 3 meses, em controles diários para mau manejo da coagulação com anticoagulante oral; consulta para dor abdominal súbita em região epigástrica, acompanhada de vômito gástrico. O exame físico teve como objetivo a defesa e a reação peritoneal. Foi solicitada tomografia computadorizada de abdome e pelve, onde foi relatado hematoma mesentérico. Como o paciente apresentava sinais de irritação peritoneal, foi realizada cirurgia de emergência com ressecção segmentar do intestino delgado. Com boa evolução pós-cirúrgica, recebeu alta no quinto dia. A anatomia patológica relata hemorragia submucosa maciça. Conclusão: Quando um paciente apresenta dor abdominal com sinais de irritação peritoneal, alteração da Relação Padronizada Internacional pelo consumo de varfarina, sem história traumática, um hematoma mesentérico espontâneo deve ser suspeitado e o tratamento cirúrgico deve ser considerado. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-06-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf image/tiff image/tiff image/tiff https://revistas.unc.edu.ar/index.php/med/article/view/23472 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 76 No. 2 (2019); 118-120 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 76 Núm. 2 (2019); 118-120 Revista da Faculdade de Ciências Médicas de Córdoba; v. 76 n. 2 (2019); 118-120 1853-0605 0014-6722 10.31053/1853.0605.v76.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/23472/23936 https://revistas.unc.edu.ar/index.php/med/article/view/23472/23937 https://revistas.unc.edu.ar/index.php/med/article/view/23472/27238 https://revistas.unc.edu.ar/index.php/med/article/view/23472/27239 https://revistas.unc.edu.ar/index.php/med/article/view/23472/27240 Derechos de autor 2019 Universidad Nacional de Córdoba |