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A rare case of intestinal bleeding in patient with colorectal carcinoma on anticoagulation treatment


Authors: M. Mýtnik;  J. Petrík;  Z. Jedináková
Authors‘ workplace: Chirurgická klinika FNsP J. A. Reimana, Prešov, Slovenská republika
Published in: Transfuze Hematol. dnes,18, 2012, No. 3, p. 130-134.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Aim:
The authors point to the risk of bleeding in patients with colorectal carcinoma, on the treatment with warfarin.

Material and methods:
The authors present a case report of the patient on treatment with warfarin. This patient has ileus due to sigmoideal cancer, and simultaneously a progressive intramural haematoma in the hepatic flexure of the colon. The patient was one of the 185 patients with colorectal cancer operated during the period 2008–2011on Surgery department of FNsP Prešov. Like in all mentioned patients all basic coagulation tests were performed (including D-dimers) and the haemocoagulation status was evaluated.

Results:
The patient belonged to the relatively small group of patients (7 cases – 3,7%), in them the prolonged coagulation tests were described. 64 patients (35%) on the long-term anticoagulation had haemocoagulation parameters in the normal range, the increased pro-coagulation activity was seen in 114 patients (61%).

Conclusion:
The haemorrhagic complications (in comparison to pro-thrombotic risk of malignant tumours) do not occur in high frequency and pose less risk in patients with colorectal carcinoma, but in association with ileous status from tumour and intramural haematoma of colon may be dangerous complication.

Key words:
colorectal cancer, bleeding, haematoma


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