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目的:华法林致自发性小肠壁内血肿(SISBH)十分罕见,保守治疗效果佳,极易误诊为外科急腹症甚至给予手术切除肠段治疗,伤害大。本文通过分析1例SISBH患者临床特点并复习文献总结特征,以提高对本病的认识。方法:对1例SISBH患者的临床表现、实验室检查、影像学表现和治疗反应进行分析,并复习文献资料,总结该病的临床特征。结果:该病多发生于老年患者,伴凝血功能明显异常、贫血,CT示肠壁弥漫性增厚,保守治疗预后良好。结论:华法林致SISBH起病隐匿,症状不典型,临床上对华法林使用者,若出现腹痛、黑便、呕吐、凝血功能明显异常者,应该想到本病的可能性。充分认识其临床特征有助于提高临床诊断率,减少漏诊、误诊。
Objective: Warfarin induced spontaneous small intestinal wall hematoma (SISBH) is very rare, conservative treatment of good results, easily misdiagnosed as surgical acute abdomen or surgical resection of bowel segment treatment, injury. In this paper, by analyzing the clinical features of a case of SISBH patients and review the characteristics of the literature to improve the understanding of the disease. Methods: The clinical manifestations, laboratory tests, imaging findings and treatment response were analyzed in 1 patient with SISBH. The literature was reviewed and the clinical features of the disease were summarized. Results: The disease occurred in elderly patients, with significant abnormal coagulation, anemia, CT showed diffuse thickening of the intestinal wall, conservative treatment prognosis is good. Conclusion: The onset of SISBH due to warfarin is insidious and the symptoms are not typical. For warfarin users, if the patients have obvious abdominal pain, melena, vomiting and coagulation abnormalities, the possibility of this disease should be considered. A full understanding of its clinical features will help to improve the clinical diagnosis rate, reduce missed diagnosis, misdiagnosis.