Mesenteric arterial thrombosis complicated with acute lymphoblastic leukemia: a case report and literature review
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摘要: 为了提高临床医师对急性白血病发生血栓并发症，尤其是肠系膜上动脉血栓形成并发症的警惕性和认识，本研究报道1例急性B淋巴细胞白血病患者在诱导治疗过程中并发肠系膜上动脉血栓形成的治疗经过，并复习相关文献。患者系64岁老年男性，2022年2月就诊皖南医学院第一附属医院血液科，诊断为急性B淋巴细胞白血病，在诱导治疗后期患者血小板计数明显上升，出现剧烈腹痛，临床症状严重，而临床体征不明显，高度怀疑肠系膜上动脉血栓形成，通过腹部增强CT和腹主动脉CTA确诊为肠系膜上动脉血栓形成。经过积极抗凝治疗，患者闭塞血栓部分再通，临床症状获得缓解。急性白血病不仅易出血，也有可能发生血栓风险，对于临床症状和体征不相符的腹痛要高度警惕肠系膜上动脉血栓形成发生，及早发现，尽早治疗。
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关键词:
- 急性淋巴细胞白血病 /
- 肠系膜上动脉血栓形成 /
- 化疗 /
- 血栓
Abstract: To improve the awareness and understanding of acute leukemia-associated thrombotic complications, particularly mesenteric arterial thrombosis for clinical physicians, this study reported a case of mesenteric arterial thrombosis in a patient with acute B-cell lymphoblastic leukemia during induction therapy. Relevant literatures were reviewed. The patient was a 64-year-old male who visiting the Department of Hematology at the First Affiliated Hospital of Wannan Medical College in February 2022. He was diagnosed with acute B-cell lymphoblastic leukemia. During the later stage of induction therapy, the patient's platelets count significantly increased, accompanied by severe abdominal pain. Although clinical signs were not typical, mesenteric arterial thrombosis was highly suspected. The diagnosis of mesenteric arterial thrombosis was confirmed through contrast-enhanced abdominal CT and abdominal aorta CTA. With aggressive anticoagulant therapy, partial reperfusion of the occluded thrombus was achieved, and the patient's clinical symptoms were relieved. Acute leukemia carries not only the risk of bleeding, but also the potential for thrombotic complications. Clinicians should be highly vigilant for the occurrence of mesenteric arterial thrombosis when there is significant abdominal pain that does not match clinical signs. Early detection and prompt treatment are crucial.-
Key words:
- acute lymphoblastic leukemia /
- mesenteric artery thrombosis /
- chemotherapy /
- thrombosis
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