Esin KURTULUŞ ÖZTÜRK, Berat ACU, Saffet ÖZTÜRK, Murat BEYHAN, Erkan GÖKÇE, Orhan ÖNALAN

Antikoagülan ilişkili abdominal hematomlarin: Klinik ve BT bulgulari

Giriş ve Amaç: Antikoagülan ilişkili abdominal hematomların klinik özelliklerini ve bilgisayarlı tomografi (BT) 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, BT 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 alani 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 BT bulgularının bilinmesi, hızlı ve doğru tanı koymayı olanak sağlar. Aynı zamanda klinik hasta yönetiminde doğrudan bir etkiye sahiptir.

Anahtar Kelimeler:

Abdominal hematom, antikoagülan tedavi, bilgisayarlı tomografi

Anticoagulant related abdominal hematomas: Clinical and CT findings

Background and Aims: We aimed to evaluate the clinical features and computed tomography(CT) findings of anticoagulant-related abdominal hematomas.Material and methods: This was a systematic retrospective study of 55 patients (mean age: 66±12 years, range 29-84 years) on anticoagulant therapy who were diagnosed with abdominal hematoma between March 2008 and May 2016.The patients were evaluated for demographic characteristics, clinical manifestations, medical history, associated factors, biochemical tests, CT findings, treatment and outcomes.Results: Warfarin was the most commonly used anticoagulant agent (72.7%), followed by enoxaparin (20%), and both warfarin and enoxaparin (7.3%). The main clinical symptoms were abdominal pain and abdominal distention. In total of 85 hematoma location, the most frequent locations were the rectus muscle sheath (50.9%) and gastrointestinal tract (30.9%). Fifteen (27.3%) patients had major hemorrhage by using criteria of the Control Anticoagulation Comittee. Conclusion: The knowledge of the most common clinical and CT findings of anticoagulant-related abdominal hematomas allows prompt and accurate diagnosis and has also direct impact on clinical management.

Keywords:

Abdominal hematoma, anticoagulant therapy, computed tomography,

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