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.
Anticoagulant-related abdominal hematomas: Clinical and CT findings
Background and Aims: We aimed to evaluate clinical features andcomputed tomography findings of anticoagulant-related abdominalhematomas. Material and Methods: We conducted a retrospectivesystematic study of 55 patients (mean age, 66±12 years; range, 29-84years) on anticoagulant therapy and diagnosed with abdominal hematomabetween March 2008 and May 2016. Patients data were evaluatedfor demographic characteristics, clinical manifestations, medicalhistory, associated factors, biochemical tests, computed tomographyfindings, treatment, and outcomes. Results: The most commonly usedanticoagulant agent was warfarin (72.7%), followed by enoxaparin(20%) and both warfarin and enoxaparin (7.3%). The main clinicalsymptoms were abdominal pain and distention. Among the total 85locations of hematomas, the most frequent locations were the rectusmuscle sheath (50.9%) and gastrointestinal tract (30.9%). According tothe Control Anticoagulation Committee criterion, 15 (27.3%) patientshad major hemorrhages. Conclusion: Prompt and accurate diagnosescan be made through better understanding the most common clinicaland computed tomography findings regarding anticoagulant-relatedabdominal hematomas. In addition, this has a direct impact on clinicalmanagement.
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