ESİN KURTULUŞ ÖZTÜRK, Berat ACU, Saffet ÖZTÜRK, MURAT BEYHAN, ERKAN GÖKÇE, ORHAN ÖNALAN

Anticoagulant-related abdominal hematomas: Clinical and CT findings

Background and Aims: We aimed to evaluate clinical features and computed tomography findings of anticoagulant-related abdominal hematomas. Material and Methods: We conducted a retrospective systematic study of 55 patients (mean age, 66±12 years; range, 29-84 years) on anticoagulant therapy and diagnosed with abdominal hematoma between March 2008 and May 2016. Patients data were evaluated for demographic characteristics, clinical manifestations, medical history, associated factors, biochemical tests, computed tomography findings, treatment, and outcomes. Results: The most commonly used anticoagulant agent was warfarin (72.7%), followed by enoxaparin (20%) and both warfarin and enoxaparin (7.3%). The main clinical symptoms were abdominal pain and distention. Among the total 85 locations of hematomas, the most frequent locations were the rectus muscle sheath (50.9%) and gastrointestinal tract (30.9%). According to the Control Anticoagulation Committee criterion, 15 (27.3%) patients had major hemorrhages. Conclusion: Prompt and accurate diagnoses can be made through better understanding the most common clinical and computed tomography findings regarding anticoagulant-related abdominal hematomas. In addition, this has a direct impact on clinical management.

Antikoagülana bağlı abdominal hematomların klinik ve BT bulguları

Giriş ve Amaç: Antikoagülan ilişkili abdominal hematomların klinik özelliklerini ve bilgisayarlı tomografi bulgularını değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu sistematik retrospektif çalışmaya Mart 2008 ile Mayıs 2016 tarihleri arasında antikoagülan tedavi altında abdominal hematom tanısı alan 55 hasta (ortalama yaş: 66±12 yıl, aralık 29-84) dahil edildi. Hastalar; demografik özellikler, klinik belirtiler, tıbbi öykü, ilişkili faktörler, biyokimyasal testler, bilgisayarlı tomografi bulguları, tedavi ve sonuçları açısından değerlendirildi. Bulgular: En sık kullanılan antikoagülan ajan warfarin (%72.7) olmakla birlikte enoksaparin kullanımı %20 ve warfarinin enoksaparin ile birlikte kullanımı %7.3 oranlarında saptandı. Ana klinik semptomlar karın ağrısı ve abdominal distansiyondu. Toplam 85 hematom alanı saptandı ve en sık görülen lokalizasyonlar rektus kas kılıfı (%50.9) ve gastrointestinal sistem (%30.9) olarak izlendi. Kontrol Antikoagülasyon Komitesinin kriterlerine göre 15 (%27.3) hastada majör kanama saptandı. Sonuç: Antikoagülan ilişkili abdominal hematomların sık görülen klinik ve bilgisayarlı tomografi bulgularının bilinmesi, hızlı ve doğru tanı koymayı olanak sağlar. Aynı zamanda klinik hasta yönetiminde doğrudan bir etkiye sahiptir.

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