Abstract：
The patient was a 72-year-old female. She had been taking rivaroxaban for chronic atrial fibrillation; however, she stopped taking it due to anemia and was hospitalized urgently. A contrast-enhanced computed tomography(CT)scan showed a 30 mm mass in the ascending colon, and a colonoscopy revealed ascending colon cancer(cT3, cN0, cM0, cStage Ⅱa). The tumor was hemorrhagic and was thought to have caused the anemia. On day 6 of hospitalization, another contrast- enhanced CT scan showed a poorly contrast-enhanced area in the left atrium, and transesophageal echocardiography revealed 2 left atrial thrombi(27 mm and 17 mm). Since early induction of anticoagulation therapy was considered, an emergency open right colectomy was performed to remove the cause of the bleeding. Intravenous heparin therapy was started the day after surgery and was switched to oral apixaban therapy on the fourth postoperative day. The postoperative course was good, and she was discharged home on the 17th postoperative day. This patient had conflicting clinical problems simultaneously; however, immediate decision-making and initiation of treatment were effective.
摘要：
患者为72岁女性。她一直在服用利伐沙班治疗慢性心房颤动；然而，她因贫血停止服用，并紧急住院。对比增强计算机断层扫描（CT）扫描显示升结肠有30毫米的肿块，结肠镜检查显示升结肠癌（cT3，cN0，cM0，cStageⅡa）。肿瘤是出血性的，被认为是导致贫血的原因。在住院的第六天，另一个对比增强CT扫描显示左心房的对比增强区域较差，经食管超声心动图显示左房血栓2处(27mm和17mm)。由于考虑早期诱导抗凝治疗，进行了紧急开放式右结肠切除术，以消除出血原因。手术后第二天开始静脉肝素治疗，并在术后第四天转为口服阿哌沙班治疗。术后病程良好,她在术后第17天出院回家.该患者同时出现了相互矛盾的临床问题；然而，即时决策和开始治疗是有效的.
