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Abstract：
Background: Hematoma of the colon is a rare hemorrhagic complication that affects patients accepting low molecular weight heparin (LMWH) therapy. Only scarce cases of colon hematoma have been reported, usually in children or patients accepting warfarin therapy. Case summary: A 76-year-old Chinese man was diagnosed with atrial fibrillation and heart failure, with cardiac function NYHA grade III on March 21, 2018. This patient was given LMWH for anticoagulation therapy and developed a colon hematoma on the third day of hospitalization. Abdominal computed tomography (CT) showed the thickening of areas of the colon up to 110 mm × 78 mm in thickness, which was a symptom of colon hematoma. The patient underwent conservative treatment successfully. On March 27, the patient\'s abdominal pain was alleviated, and a CT scan showed that the intestinal hematoma was absorbed. Conclusions: The most frequent minor bleeding events of LMWH anticoagulation are hemorrhage and subcutaneous hematoma. This case demonstrated that bowel hematoma despite its low incidence should be considered as an ADR of LMWH therapy, especially among patients who present with gastrointestinal symptoms.
摘要：
背景：结肠血肿是一种罕见的出血并发症，会影响接受低分子量肝素（LMWH）治疗的患者。只有罕见的结肠血肿病例被报道，通常在接受华法林治疗的儿童或患者中。病例总结：一名76岁的中国男子被诊断为房颤和心力衰竭，2018年3月21日心脏功能NYHA分级为III级。该患者接受LMWH抗凝治疗，并在住院第三天出现结肠血肿。腹部计算机断层扫描（CT）显示结肠厚度高达110mm×78mm的区域增厚，这是结肠血肿的症状.患者经保守治疗成功。3月27日，患者腹痛缓解，CT扫描显示肠道血肿被吸收了.结论：LMWH抗凝治疗最常见的轻微出血事件是出血和皮下血肿。该病例表明，尽管肠血肿发生率较低，但应将其视为LMWH治疗的ADR。尤其是出现胃肠道症状的患者。
