Anticoagulant related abdominal hematomas: Clinical and CT findings

Year 2018, Volume: 17 Issue: 2, 50 - 61, 24.09.2018

Esin Kurtuluş Öztürk Berat Acu Saffet Öztürk Murat Beyhan Erkan Gökçe Orhan Önalan

https://doi.org/10.17941/agd.425110

Cited By: 1

Abstract

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

Antikoagülan ilişkili abdominal hematomlarin: Klinik ve BT bulgulari

Abstract

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.

Keywords

Abdominal hematom, antikoagülan tedavi, bilgisayarlı tomografi

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