A case of abdominal aortic aneurysm presenting as symptomatic disseminated intravascular coagulation treated with endovascular aneurysm repair and postoperative administration of Nafamostat mesylate.

IF 0.7 Q4 SURGERY Surgical Case Reports Pub Date : 2024-05-16 DOI:10.1186/s40792-024-01926-6

Shinichi Tanaka, Takahiro Ohmine

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Abstract

Background: Cases of abdominal aortic aneurysm discovered as purpura on the extremities with disseminated intravascular coagulation (DIC) are rare. The number of currently established strategies for the control of DIC with aortic aneurysm is limited.

Case presentation: An 85-year-old woman was referred to the hematology department because of purpura on her shoulder and thigh. Enhanced fibrinolytic-type DIC was diagnosed by a blood test. Enhanced computed tomography (CT) revealed 60-mm abdominal aortic and 42-mm right common iliac aneurysms. We performed endovascular aneurysm repair (EVAR) and coiling of the right internal iliac artery with postoperative administration of Nafamostat mesylate. The patient promptly recovered from DIC, and the purpura gradually disappeared.

Conclusions: We safely performed EVAR with postoperative administration of Nafamostat mesylate for an abdominal aortic aneurysms that presented as symptomatic DIC.

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一例表现为症状性弥散性血管内凝血的腹主动脉瘤患者，通过血管内动脉瘤修补术和术后服用甲磺酸纳伐司他得到了治疗。

背景：腹主动脉瘤在四肢发现紫癜并伴有弥散性血管内凝血（DIC）的病例非常罕见。目前控制主动脉瘤 DIC 的既定策略数量有限：一名 85 岁的妇女因肩部和大腿出现紫癜而被转诊至血液科。经血液化验确诊为增强型纤溶型 DIC。增强计算机断层扫描（CT）显示腹主动脉瘤 60 毫米，右髂总动脉瘤 42 毫米。我们为患者实施了血管内动脉瘤修补术（EVAR）和右髂内动脉卷曲术，并在术后服用甲磺酸纳伐司他。患者很快从 DIC 中恢复过来，紫癜也逐渐消失：我们对出现症状性 DIC 的腹主动脉瘤安全地实施了 EVAR，术后服用了甲磺酸纳伐司他。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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