妊娠并发肝外门静脉闭塞和门静脉血栓:病例报告。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Cureus Pub Date : 2024-10-26 eCollection Date: 2024-10-01 DOI:10.7759/cureus.72457
Shingo Hosomi, Rie Oyama, Chizuko Isurugi, Takanori Sato, Tsukasa Baba
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引用次数: 0

摘要

我们报告了这样一例病例:一名有肝外门静脉阻塞(EHPVO)病史的 38 岁女性怀孕后出现了门静脉血栓。在消化内科和心脏内科的干预下,她顺利分娩。她在妊娠八周时因腿部明显水肿转诊至我科,我们通过对比增强 CT 发现她患有肝外门静脉阻塞(EHPVO)、门静脉血栓和左肺动静脉瘘。因此,我们开始皮下注射肝素 10,000 单位/天,作为预防性抗凝治疗。我们在妊娠 36 周时进行了紧急剖宫产手术。术后,为产妇持续输注肝素。术后第 11 天,术后进展良好,因此将肝素改为口服华法林,患者于当天出院。妊娠期间,由于循环血量增加,静脉曲张破裂、高氨血症和肺动脉高压的风险也会增加。在这一病例中,医生与其他科室合作进行了精心的围产期管理,最终使患者顺利产下一子。
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Pregnancy Complicated by Extrahepatic Portal Vein Occlusion and Portal Vein Thrombosis: A Case Report.

We report the case of a 38-year-old woman with a history of extrahepatic portal vein obstruction (EHPVO) who became pregnant and developed portal vein thrombosis. She gave birth after intervention by gastroenterology and cardiology. She was referred to our department due to significant leg edema at eight weeks of gestation, and we noticed EHPVO, portal vein thrombosis, and left pulmonary arteriovenous fistula by contrast-enhanced CT. Therefore, subcutaneous heparin injections of 10,000 units/day were started as a preventive anticoagulant therapy. We performed an emergency cesarean section at 36 weeks of gestation. After surgery, the mother was administered a continuous heparin infusion. On the 11th day after surgery, the postoperative progress was good, so heparin was switched to oral warfarin, and the patient was discharged on the same day. During pregnancy, the risk of varicose vein rupture, hyperammonemia, and pulmonary hypertension increases due to an increase in circulating blood volume. This was a case in which careful perinatal management was performed in collaboration with other departments, resulting in a live birth.

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