@article{oai:ir.kagoshima-u.ac.jp:00014965,
 author = {保坂, 優斗 and 石神, 純也 and 恵, 浩一 and 瀬戸山, 徹郎 and 夏越, 祥次},
 issue = {1-3},
 journal = {鹿児島大学医学雑誌, Medical journal of Kagoshima University},
 month = {},
 note = {A 47-year-old man was referred to our hospital with the chief complaint of abdominal pain. Contrast-enhanced Computed Tomography (CT) revealed thrombus in the superior mesenteric vein. Based on a diagnosis of superior mesenteric venous thrombosis (SMVT), conservative treatment was started with heparin and urokinase. However, CT performed on the following day revealed an area with poor blood flow in the small intestine; therefore, emergency surgery was performed. After resection of approximately 3 m of necrotized small intestine, anastomosis was performed. Immediately after surgery, nafamostat was administered. From postoperative day 3, heparin was continuously administered. On postoperative day 5, pulmonary thrombosis appeared on CT findings; therefore, the heparin dose was increased. Nevertheless, on postoperative day 7, the patient’s platelet count decreased to 54,000 /μl. Therefore, heparin-induced thrombocytopenia (HIT) was suspected, and heparin administration was discontinued, while continuous administration of argatroban was started. Discontinuation  of heparin resulted in normalization of platelet count; contrast-enhanced CT indicated that the size of pulmonary thrombosis had decreased. The patient subsequently progressed well and was discharged to his home on postoperative day 28. In SMVT, the formation of a thrombus in the superior mesenteric vein causes impaired blood flow in the intestinal tract, due to congestion. Heparin is primarily used for conservative treatment in the acute phase. HIT is an adverse effect of heparin administration that can sometimes cause severe thromboembolism. Here, we describe a rare case of HIT that occurred during pulmonary thromboembolism treatment following surgery for SMVT.},
 pages = {6--13},
 title = {上腸間膜静脈血栓症にヘパリン起因性血小板減少症を併発した1例},
 volume = {71},
 year = {2019}
}