下腔静脉损伤出血疑难解答病例报告

Q4 Medicine IJU Case Reports Pub Date : 2024-09-01 DOI:10.1002/iju5.12782

Tadamasa Shibuya, Toru Inoue, Tadasuke Ando, Toshitaka Shin

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摘要

导言：我们报告了一例使用明胶-凝血酶原基质对下腔静脉损伤出血进行故障排除的病例：一名 58 岁的男性因右侧肾上腺腺瘤导致亚临床库欣综合征而接受了机器人辅助肾上腺部分切除术。手术过程中，在解剖肾上腺和下腔静脉之间时，由于下腔静脉损伤导致出血。尽管尝试了止血，但由于出血导致视力不佳，使用人血纤维蛋白原-凝血酶原贴片和缝合都很困难。最终使用明胶-凝血酶矩阵止血，并用纱布将其准确地贴在出血点上。结论：明胶-凝血酶原基质可能是一种有效的止血方法：结论：明胶-凝血酶矩阵可有效处理相对较小的下腔静脉损伤。

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A case report of troubleshooting against bleeding from inferior vena cava injury

Introduction

We report a case of troubleshooting against bleeding from an inferior vena cava injury using a gelatin–thrombin matrix.

Case presentation

A 58-year-old man underwent robot-assisted partial adrenalectomy for a right adrenal adenoma causing subclinical Cushing's syndrome. During the surgery, while dissecting between the adrenal gland and the inferior vena cava, bleeding occurred secondary to an inferior vena cava injury. Despite attempts at hemostasis, applying a human fibrinogen–thrombin patch and suturing were both difficult because of poor vision secondary to the bleeding. Hemostasis was ultimately achieved using a gelatin–thrombin matrix, which was accurately placed on the bleeding point using gauze. Open conversion was hence avoided, allowing the completion of the surgery as planned.