BACKGROUND Hip fractures have become a severe public health problem, especially in very elderly patients. Most of them are treated with low molecular weight heparin as prophylaxis or treatment of venous thromboembolism. Heparin-induced thrombocytopenia is one of the complications induced by low molecular weight heparin, which may cause poor prognosis. However, there is not enough awareness for heparin-induced thrombocytopenia in very elderly trauma patients. CASE PRESENTATION We report a case of hip fracture with heparin-induced thrombocytopenia in a very elderly patient. The patient developed heparin-induced thrombocytopenia, digestive hemorrhage and acute colonic pseudo-obstruction after the use of low molecular weight heparin, which eventually led to death. CONCLUSIONS This is the first case report of digestive hemorrhage and acute colonic pseudo-obstruction in heparin-induced thrombocytopenia patients with major trauma. This case highlights the severity of HIT in very elderly patients with hip fractures using low molecular weight heparin, and the need for platelet monitoring in these patients. We indicate that there may be a correlation of pathogenesis between digestive hemorrhage and acute colonic pseudo-obstruction in heparin-induced thrombocytopenia patients.

中文翻译：

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老年髋部骨折患者抗凝治疗后肝素引起的血小板减少和急性结肠假性阻塞：一例报告。

背景技术髋部骨折已经成为严重的公共卫生问题，尤其是在年纪大的患者中。它们中的大多数都用低分子量肝素治疗，以预防或治疗静脉血栓栓塞。肝素诱导的血小板减少症是低分子量肝素诱导的并发症之一，可能导致不良预后。然而，对于非常年老的创伤患者，肝素引起的血小板减少症认识不足。病例介绍我们报告了一名非常年老的患者的髋部骨折伴肝素诱导的血小板减少症。使用低分子量肝素后，患者发生肝素诱导的血小板减少，消化道出血和急性结肠假性阻塞，最终导致死亡。结论这是肝素引起的严重血小板减少症患者消化道出血和急性结肠假性阻塞的第一例报道。该病例突出显示了在使用低分子量肝素的老年髋部骨折患者中HIT的严重性，以及这些患者中血小板监测的必要性。我们指出，在肝素诱导的血小板减少症患者中，消化性出血与急性结肠假性梗阻之间的发病机理可能相关。