PDF(Pubmed)
Abstract：
We present the case of an adult man with cardiofaciocutaneous syndrome, who initially presented to the emergency department with severe abdominal pain and distension, but was diagnosed with cardiac tamponade on CT after distended neck veins and tachycardia were identified on examination. He had emergency pericardial drainage to relieve the haemopericardium and was treated with colchicine. He was further found to be deficient in factors II, VII and X despite not being on warfarin, and was therefore supplemented with vitamin K. This confirms a diagnosis of vitamin K deficiency, likely multifactorial from malabsorption due to chronic intestinal pseudo-obstruction, small bowel obstruction and possibly exacerbated by subsequent ciprofloxacin use for small intestine bacterial overgrowth. This is the first report of spontaneous haemopericardium secondary to vitamin K deficiency in an adult patient not on anticoagulation, and is an important learning point due to the life-threatening progression of the haemopericardium and cardiac tamponade.
摘要：
我们介绍了一个患有心脏皮肤综合征的成年男子的病例，最初出现严重腹痛和腹胀的急诊科，但在检查发现颈部静脉扩张和心动过速后，CT诊断为心脏压塞。他进行了紧急心包引流以缓解心包积血，并接受了秋水仙碱治疗。进一步发现他在因素二方面有缺陷，VII和X尽管没有服用华法林，因此补充了维生素K。这证实了维生素K缺乏症的诊断，慢性假性肠梗阻可能是多因素导致的吸收不良，小肠梗阻，随后使用环丙沙星治疗小肠细菌过度生长可能会加剧。这是第一次报告的成人患者继发于维生素K缺乏的自发性心包血，并且是一个重要的学习点，由于危及生命的心包和心脏填塞的进展。
