A Case of Successful Management of Mesenteric Ischemia in a Patient with Severe Coagulopathy Caused by Dabigatran

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  • Ogura Koichiro
    Department of Surgery, National Hospital Organization Chiba Medical Center
  • Satomi Daisuke
    Department of Surgery, National Hospital Organization Chiba Medical Center
  • Ishige Komei
    Department of Surgery, National Hospital Organization Chiba Medical Center
  • Fukutomi Satoshi
    Department of Surgery, National Hospital Organization Chiba Medical Center
  • Morishima Yuichi
    Department of Surgery, National Hospital Organization Chiba Medical Center

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Other Title
  • ダビガトランによる著明な凝固障害を合併した腸管壊死に対して手術と集学的治療を行い救命した1例
  • ダビガトラン ニ ヨル チョメイ ナ ギョウコ ショウガイ オ ガッペイ シタ チョウカン エシ ニ タイシテ シュジュツ ト シュウガクテキ チリョウ オ オコナイ キュウメイ シタ 1レイ

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<p>A 73–year–old woman was admitted to our hospital complaining of acute abdominal pain. We diagnosed her as having extensive mesenteric ischemia and extreme coagulopathy induced by the oral dabigatran she was taking. Enterectomy and Hartmann procedure were performed as emergency operations. Serious coagulopathy and active bleeding persisted for two days after the surgery. Finally, the bleeding stopped, and the patient was discharged from our hospital on hospital day 45. Blood concentrations of dabigatran may increase significantly in some patients, for a variety of reasons, and these patients are at a high risk for developing hemorrhagic complications. Such patients may be treated with antagonists or by blood purification therapy. Doctors dealing with abdominal emergencies need to be aware of the adverse effects of dabigatran.</p>

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