A case of hemorrhagic shock due to large extrapleural hematoma during TS-1 chemotherapy

DOI
  • Ikebe Ryokan
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Okubo Hikari
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Osaka Masashi
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Oshiro Takuya
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Saito Makiko
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Saito Noriko
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Namiki Mizuho
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Takeda Munekazu
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University
  • Yaguchi Arino
    Department of Critical Care and Emergency Medicine, Tokyo Women’s Medical University

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Other Title
  • TS-1の化学療法中に胸壁外筋肉内血腫から出血性ショックに至った1例

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<p>A 66-year-old man was transferred to our emergency room due to hemorrhagic shock. He had been using warfarin for atrial fibrillation, and adjuvant chemotherapy with TS-1 was performed for gastric cancer six weeks before. His laboratory data showed a hemoglobin value of 4.9 g/dL, PT/INR and aPTT value of 7.41, 79.6 seconds, respectively. CT images showed large intramuscular hematoma in his lateral thoracic region, and small volumes of contrast medium extravasation were observed. He responded to fluid administration, and coagulation function was restored. TS-1 can enhance the anticoagulant activity of warfarin, so close follow-up monitoring of PT/INR should be arranged.</p>

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