TY -的A2 Espinola-Zavaleta Nilda盟——Abbasi丹麦盟——Vanhook Jeffrey e . AU - Salartash Khashayar盟利,霍华德PY - 2018 DA - 2018/11/21 TI -肠系膜血肿的诊断和管理少见破裂后经导管主动脉瓣置换术(TAVR):病例报告和文献之回顾SP - 6273538六世- 2018 AB -我们报告一例78岁女性历史的舒张期心衰和阵发性心房纤维性颤动药apixaban呈现恶化气短。她接受了技术超声心动图显示严重主动脉瓣狭窄阀面积0.8平方厘米。冠状动脉造影未显示显著的冠状动脉疾病。CT胸部、腹部和骨盆并没有显示出任何证据的血肿或解剖。患者定于施行TAVR。前病人apixaban停止程序。她收到了肝素在过程。她成功地接受了左施行主动脉瓣置换术。手术后不久,她抱怨腹痛,成为低血压患者。血压76/44毫米汞柱(图58)。 Hemoglobin dropped to 8.1 g/dl (baseline 13). Stat CT abdomen and pelvis showed a large volume of hemorrhage in the peritoneal cavity. CTA of abdomen showed no evidence of aortic aneurysm or dissection but active extravasation below the inferior aspect of the spleen. Catheterization of the superior mesenteric artery (SMA) identified ileal branch of SMA as the source of bleeding. Embolization using gel foam slurry followed by a coil insertion was performed. Repeat angiogram demonstrated continued extravasation through arcade collaterals. A rapid exploration of the abdominal cavity revealed ruptured mesenteric hematoma. Evacuation of hematoma was performed. Portion of small ileum and bleeding mesenteric branch vessel was resected. Her condition stabilized with no postoperative bleeding and she was discharged on warfarin postoperatively. Use of antithrombotic therapy increases risk of bleeding in TAVR patients. Mesenteric hematoma rupture if not identified can be life-threatening. We believe that this is the first reported case of mesenteric hematoma rupture after a TAVR procedure. SN - 2090-6986 UR - https://doi.org/10.1155/2018/6273538 DO - 10.1155/2018/6273538 JF - Case Reports in Vascular Medicine PB - Hindawi KW - ER -