Anticoagulant-induced intramural hematoma of the jejunum

Abstract

Abdominal pain and abnormal coagulation profile in patients on oral anticoagulants should alert the clinician to consider intramural hematoma. Early diagnosis is essential, as patients are successfully managed conservatively with good outcome.

Antikoagülan ilişkili abdominal hematomlarin: Klinik ve BT bulgulari

“…Spontaneous hematomas may occur in the esophagus and gastric wall. These may be submucosal, intramural, intraluminal, intramesenteric, and retroperitoneal, particularly, when the duodenum is involved (18,31). Comparatively, in this study, the ileum (36% of GITHs) was the most frequent location, followed by the jejunum (28%), duodenum, stomach, colon, and rectum ( Figure 5-7).…”

“…The most common cause of spontaneous intestinal hematoma is the anticoagulant use. Other known causes are hematologic disorders, lymphoproliferative diseases, collagenosis, vasculopathies, peptic ulcers, and pancreatitis (31). Spontaneous hematomas are rare and they tend to involve the jejunum as well as longer multiple segments.…”

Spontaneous duodenal haematoma in a patient taking rivaroxaban

“…Reversal or correction of anticoagulation is the mainstay of treatment in warfarin‐induced ISBH 3,6 . The requirement of parenteral nutrition is rare, and associated with a prolonged hospital stay, as with our patient 1,9 …”

“…Recommended management is predominantly conservative in both traumatic and spontaneous IDH 1,7,9 . However, in one review of the literature, 17% of patients required surgical input for complications such as bowel obstruction 1 .…”