How to Cite
Abstract
Relevance. Cancer patients need pharmacological thromboprophylaxis during chemotherapy. However, the use of anticoagulant and antiplatelet drugs is associated with an increased risk of gastrointestinal bleeding, which is easier to diagnose in a multidisciplinary hospital, where the most effective treatment can be provided.
Clinical case. The presented case of severe bleeding from the small intestine against the background of perioperative chemotherapy in a gastric cancer patient illustrates the difficulty in diagnosing and treating this complication. The following was done to diagnose the source of bleeding: multislice computed tomography angiography and radiocontrast angiography. The bleeding was stopped using endovascular embolization of blood vessels. Despite the complexity of the situation, modern equipment in a multidisciplinary hospital made possible timely identification and high-tech, minimally invasive management of bleeding from the jejunal artery.
References
Ba M.C., Qing S.H., Huang X.C., et al. Diagnosis and treatment of small intestinal bleeding: retrospective analysis of 76 cases. World J Gastroenterol. 2006. 12(45); 7371-4.-DOI: https://doi.org/10.3748/wjg.v12.i45.7371.
Плотникова Е.Ю., Исаков Л.К., Синькова М.Н., Гуляева Е.Н. Гастроинтестинальные кровотечения на фоне приема антикоагулянтов: риск возникновения, профилактика и лечение. Терапия. 2020; 7_2020: 43-53.-DOI: https://doi.org/10.18565/therapy.2020.7.43-53. [Plotnikova E.Yu., Isakov L.K., Sinkova M.N., Gulyaeva E.N. Gastrointestinal bleeding against the background of taking anticoagulant drugs: risk of occurrence, prevention and treatment. Therapy. 2020; 7_2020: 43-53.-DOI: https://doi.org/10.18565/therapy.2020.7.43-53. (In Rus)]
Сомонова О.В., Антух Э.А., Варданян А.В., и др. Практические рекомендации по профилактике и лечению тромбоэмболических осложнений у онкологических больных. Злокачественные опухоли. 2021; 11(3s2-2): 145-55.-DOI: http://dx.doi.org/10.18027/2224-5057-2021-11-3s2-47. [Somonova O.V., Antukh E.A., Vardanyan A.V., et al. Practical recommendations for the prevention and treatment of thromboembolic complications in cancer patients. Malignant Tumours. 2021; 11(3s2-2): 145-55. .-DOI: http://dx.doi.org/10.18027/2224-5057-2021-11-3s2-47. (In Rus)].
Wilts I.T., Bleker S.M., Van Es.N., et al. Safety of anticoagulant treatment in cancer patients. Expert Opin Drug Saf. 2015; 14(8): 1227-36.-DOI: https://doi.org/10.1517/14740338.2015.1052739.
Trujillo-Santos J., Nieto J.A., Ruíz-Gamietea A., et al. Bleeding complications associated with anticoagulant therapy in patients with cancer. Thromb Res. 2010; 125: S58–61.-DOI: https://doi.org/10.1016/S0049-3848(10)70015-3.
Ng H.J., Crowther M.A. New anti-thrombotic agents: emphasis on hemorrhagic complications and their management. Semin Hematol. 2006; 43(1 Suppl 1):S77-83.-DOI: https://doi.org/10.1053/j.seminhematol.2005.11.023.
Crowther M.A., Warkentin T.E. Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agents. Blood. 2008; 111(10): 4871-9.-DOI: https://doi.org/10.1182/blood-2007-10-120543.
Ливзан М.А., Ширинская Н.В. Гастроинтестинальные осложнения у пациентов, получающих антитромботическую и антикоагулянтную терапию. Consilium Medicum. 2019; 21 (8): 71-73.-DOI: 10.26442/20751753.2019.8.190531. [Livzan M.A., Shirinskaya N.V. Gastrointestinal complications in patients receiving antithrombotic and anticoagulant therapy. Consilium Medicum. 2019; 21 (8): 71-73.-DOI: 10.26442/20751753.2019.8.190531. (In Rus)].
Romãozinho J.M., Pontes J.M., Lérias C., et al. Dieulafoy's lesion: management and long-term outcome. Endoscopy. 2004; 36(5): 416-20.-DOI: https://doi.org/10.1055/s-2004-814322.
Gerson L.B. Outcomes associated with deep enteroscopy. Gastrointest Endosc Clin N Am. 2009; 19(3): 481-96.-DOI: https://doi.org/10.1016/j.giec.2009.04.007.
Pennazio M. Enteroscopy in the diagnosis and management of obscure gastrointestinal bleeding. Gastrointest Endosc Clin N Am. 2009; 19(3): 409-26.-DOI: https://doi.org/10.1016/j.giec.2009.04.002.
Hansel S.L., Decker G.A., Shiff A.D. Thirty years of overt, obscure GI bleeding solved by modern technology. Gastrointest Endosc. 2009; 70(3): 595-7.-DOI: https://doi.org/10.1016/j.gie.2008.12.044.
Cui J., Huang L.Y., Wu C.R. Small intestinal vascular malformation bleeding: diagnosis by double-balloon enteroscopy combined with abdominal contrast-enhanced CT examination. Abdom Imaging. 2012; 37(1): 35-40.-DOI: https://doi.org/10.1007/s00261-011-9730-0.
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