前切除术后急性主动脉血栓-一种罕见的并发症

Muhamad Izwan Ismail, H. Chong, Wan Khamizar Wan Khazim
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摘要

导读:在世界范围内,前切除术是一种常用的直肠癌手术。它与广泛的并发症相关,包括出血、盆腔败血症、伤口感染、吻合口破裂、深静脉血栓形成、周围神经损伤、阳痿和泌尿功能障碍。然而,主动脉前切除术后急性血栓形成是非常罕见的并发症。病例介绍:我们报告一个罕见的病例主动脉血栓形成在67岁的男士直肠癌前切除术后。讨论:我们也讨论其可能的原因,因为有许多假设的原因,这一毁灭性的并发症。手术时间延长、肿瘤患者凝血异常、取石位置和周围血管疾病的存在是导致本例患者罕见的急性主动脉血栓形成的易感因素。术后应对四肢进行标准的常规神经血管检查,以帮助早期发现任何神经血管并发症。在接受大手术的高风险手术患者中,强烈建议使用预防性抗凝剂,如fondaparinux、低分子量肝素或低剂量未分离肝素,以帮助预防术后血栓栓塞发作。
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Acute Aortic Thrombosis Following Anterior Resection - A Rare Complication
INTRODUCTION : Anterior resection is a commonly performed surgery for rectal cancer worldwide. It is associated with a wide spectrum of complications which include haemorrhage, pelvic sepsis, wound infection, anastomotic breakdown, deep vein thrombosis, peripheral nerves injury, impotence and urological dysfunction. However acute aortic thrombosis post anterior resection is a very rare complication. CASE PRESENTATION : We report a rare case of aortic thrombosis in a 67 year old gentleman following anterior resection for rectal cancer. DISCUSSION : We also discuss its possible causes as there are many postulations to the cause of this devastating complication. Prolonged surgery, abnormal blood coagulation in cancer patient, lithotomy position and the presence of peripheral vascular disease are predisposing factors contributing to this rare acute aortic thrombosis in our patient. A standard routine neurovascular examination of the extremities should be done in the postoperative period to help detect early any neurovascular complication. The use of prophylactic anticoagulant such as fondaparinux, low molecular weight heparin or low dose unfractionated heparin are strongly recommended in high risk surgery patients undergoing a major surgery which helps prevent thromboembolic episode following surgery.
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