Lessons Learned from a Case of Abdominal Aortic Aneurysm Accompanied by Unstable Coagulopathy
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- Katsuyuki Hoshina
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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- Makoto Kaneko
- Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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- Akihiro Hosaka
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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- Hiroyuki Okamoto
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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- Kunihiro Shigematsu
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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- Tetsuro Miyata
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
書誌事項
- 公開日
- 2012
- 資源種別
- journal article
- 権利情報
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- http://creativecommons.org/licenses/by/3.0/
- DOI
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- 10.1155/2012/265860
- 公開者
- Hindawi Limited
この論文をさがす
説明
<jats:p>Preoperative examination for abdominal aortic aneurysms (AAAs) occasionally reveals an abnormal decrease in coagulation factors and thrombocytopenia, fulfilling the criteria for disseminated intravascular coagulation (DIC). Treatment of the underlying disorder is indispensable for alleviating DIC. We report an uncommon case of a patient with AAA and DIC who showed prolonged thrombocytopenia despite successful treatment of AAA and temporary recovery of coagulation factors. A 70-year-old man presented with AAA and shaggy aorta accompanied by DIC and underwent aneurysmectomy. Combined preoperative use of nafamostat mesilate and recombinant human soluble thrombomodulin was effective in controlling DIC. Although recovery of coagulation factors was observed after surgery, the thrombocytopenia continued throughout the postoperative course and was refractory to platelet transfusion. Because HPA antibody and PA-IgG were present, a trial administration of<jats:italic>γ</jats:italic>-globulin was performed; this resulted in rapid improvement of thrombocytopenia. Although DIC recurred again 2 weeks thereafter, coagulation factors subsequently recovered without any medication.</jats:p>
収録刊行物
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- Case Reports in Vascular Medicine
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Case Reports in Vascular Medicine 2012 1-4, 2012
Hindawi Limited