Oral Antikoagülan Tedaviye Baðlý Geliþen Spontan Hemotoraks

Oral antikoagülan tedavisi yaygýn bir þekilde birçok hastalýk durumunda kullanýlmaktadýr ve en sýk kullanýlan etken madde ise varfarin'dir. Varfarin kullanýmýnýn en önemli komplikasyonu kanamadýr ve bu komplikasyonun nadir bir formu ise spontan hemotoraks'dýr. Olgumuz 53 yaþýnda bayan hasta, derin ven trombozu ve pulmoner emboli tanýlarý ile varfarin tedavisi almakta idi. International Normalized Ratio (INR) deðeri 2,84 ve beklenen aralýkta (2-3) idi. Tedavinin üçüncü ayýnda hastamýzda nadir komplikasyon olan spontan hemotoraks geliþti. Antikoagülan kullanýlmasýndan dolayý hastamýza göðüs tüpü takýlmadý ve tekrarlanan teropötik torasentezler ile hemotoraks tedavi edildi. Bu olguda da görüldüðü gibi oral antikoagülan kullanan hastalarda INR deðeri normal olsa bile kanamanýn geliþebileceðini ve hemotoraksýn tedavi seçenekleri arasýnda terapötik torasentezin de olabileceðini vurgulamak istedik.

Spontaneous Hemothorax Due to Oral Anticoagulant Therapy

Oral anticoagulant treatment is widely used in many diseases, with warfarin being the most commonly used active ingredient. The most important complication of warfarin use is bleeding and a rare form of this complication is spontaneous hemothorax. The current case was a 53-year-old female patient receiving warfarin therapy with the diagnosis of deep vein thrombosis and pulmonary embolism. The value of her International Normalized Ratio (INR) was 2.84, and within the expected range (2-3). At the third month of the treatment, the patient developed a rare complication of spontaneous hemothorax. Due to the use of an oral anticoagulant, a chest tube was not inserted in the patient and hemothorax was treated with repeat therapeutic thoracentesis. In this case, the researchers wanted to emphasize that in patients treated with oral anticoagulants, INR, even if normal, bleeding may develop and therapeutic thoracentesis is the one of the treatment options for hemothorax.