Spontaneous intramural small-bowel hematoma secondary to anticoagulant therapy: a case series

Spontaneous small-bowel hematomas most commonly involve the jejunum, followed by the ileum and duodenum, and occur in patients who receive excessive anticoagulation with phenprocoumon/warfarin or who have additional risk factors for bleeding. We report three cases of intramural small-bowel hematoma,...

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Published inMedizinische Klinik, Intensivmedizin und Notfallmedizin Vol. 108; no. 2; pp. 144 - 148
Main Authors Abdel Samie, A., Sun, R., Huber, A., Höpfner, W., Theilmann, L.
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer-Verlag 01.03.2013
Subjects
Aged, 80 and over
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy
Cholangiopancreatography, Endoscopic Retrograde
Critical Care Medicine
Duodenal Diseases - chemically induced
Duodenal Diseases - diagnosis
Emergency Medicine
Female
Gastrointestinal Hemorrhage - chemically induced
Gastrointestinal Hemorrhage - diagnosis
Hematoma - chemically induced
Hematoma - diagnosis
Humans
Image Enhancement
Intensive
Internal Medicine
Intestine, Small
Jejunal Diseases - chemically induced
Jejunal Diseases - diagnosis
Kasuistiken
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Phenprocoumon - adverse effects
Phenprocoumon - therapeutic use
Tomography, X-Ray Computed
Ultrasonography
Antikoagulanzientherapie
Intestinal hematoma
Dünndarm
Small bowel
Fallserie
Case series
Phenprocoumon
Intestinales Hämatom
Anticoagulant therapy
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Summary:Spontaneous small-bowel hematomas most commonly involve the jejunum, followed by the ileum and duodenum, and occur in patients who receive excessive anticoagulation with phenprocoumon/warfarin or who have additional risk factors for bleeding. We report three cases of intramural small-bowel hematoma, all complications of treatment with phenprocoumon, which nowadays is used extensively for therapeutic and prophylactic purposes. Diagnosis can be readily attained by sonography and confirmed using computed tomography. Early diagnosis is crucial because most patients can be treated successfully without surgery. Based on this experience and data from the literature, conservative treatment is recommended for intramural intestinal hematomas, when other complications needing laparotomy have been excluded.
ISSN:2193-6218
2193-6226
DOI:10.1007/s00063-012-0184-0