1 cases of warfarin-induced abdominal diagnosis and treatment of spontaneous bleeding.docVIP

 PAGE \* MERGEFORMAT 9 1 cases of warfarin-induced abdominal diagnosis and treatment of spontaneous bleeding Author: Xiao-Ping Yang Mo by Gang Bu Jianguo Bin [Keywords:] warfarin spontaneous abdominal hemorrhage Warfarin-induced spontaneous abdominal hemorrhage is a rare acute abdomen, the disease could easily lead to misdiagnosis, but in recent years, domestic and foreign-related cases reported a growing trend, such as warfarin-induced whole body, abdomen, digestive tract, urinary tract Road, bronchus, accessories and bleeding [1,2]. This study one cases of warfarin-induced spontaneous abdominal hemorrhage. Are reported below. A clinical data Patients, female, 49 years old. 4d hospital because of right upper quadrant pain. Physical examination: anemia appearance, consciousness clear, yellow skin and sclera without dye, slightly bulging abdomen, abdominal soft, right upper quadrant tenderness without rebound tenderness, Murpher’s sign (-), shifting dullness (-), and normal bowel sounds. There are 2-year history of gallbladder stones, recurrent, in January before the attack time, cephalosporins, and metronidazole to ease anti-inflammatory treatment after about 5d. Emergency abdominal B-confirmed: multiple gallbladder stones with cholecystitis. Patients with irregular menstrual ordinary times, the amount of the high side. To be ‘chronic calculous cholecystitis with acute exacerbation’ Emergency accept this admission, to be anti-inflammatory rehydration, treatment of spasticity and so on. Admission is about 10h, with chest tightness in patients with significant abdominal distension, examination: anemia appearance, body scattered in the skin petechia petechiae, abdominal bulge, abdominal soft, right upper quadrant tenderness, I abdomen without tenderness, no rebound tenderness, shifting dullness (+), weak bowel sounds, abdominal puncture, see the non-coagulation of peritoneal fluid. Blood count showed: WBC 11.1 * 109 / L, neutrophils 71.6%, hemoglobin 44g / L,