Colon Obstruction due to an Anticoagulant Induced Intramural Haematoma- A Rare Case Report

Lobo, Lancelot

doi:10.7860/jcdr/2013/5283.2899

Cited by 16 publications

(20 citation statements)

References 4 publications

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“…3,5 The patients can admit with obstruction at the level of the small intestine and colon. 6 In addition, abdominal pain is the most common symptom. 7 Our patient was admitted with abdominal pain and diarrhea.…”

Section: Discussionmentioning

confidence: 99%

A Rare Complication of Anticoagulant Use: Colonic Intramural Hematoma-Case Report

Özdemir¹

2019

tjcd

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Section: Discussionmentioning

confidence: 99%

A Rare Complication of Anticoagulant Use: Colonic Intramural Hematoma-Case Report

Özdemir¹

2019

tjcd

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“…As in our experience, it is reasonable to administer medical treatment first if the patient's vital signs are stable. Surgical treatment should be reserved for patients with an uncertain diagnosis and/or those who exhibit signs of intestinal necrosis or peritonitis or a deteriorating condition despite medical treatment (38).…”

Section: Discussionmentioning

confidence: 99%

Supportive Management Resolved a Colonic Intramural Hematoma in an Anticoagulant User

et al. 2014

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Intramural hematomas of the colon are rare. Intramural hematomas of the gastrointestinal tract often result from blunt trauma, although they may also occur spontaneously in patients taking anticoagulants or those with blood dyscrasia. Affected patients present with abdominal pain and lower gastrointestinal bleeding, as well as occasional signs of intestinal obstruction. The diagnosis is made using colonoscopy and abdominal CT. Resection of the involved bowel segment is accepted as the standard therapy; however, experience with conservative treatment has also been reported. We herein report the case of a 62-year-old woman taking warfarin who was diagnosed with a colonic intramural hematoma and completely recovered with conservative management.

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“…Oral anticoagulants are used for reasons like atrial fibrillation and venous thrombosis. One small intestinal hematoma was reported in 2500 cases using oral anticoagulants [2]. Ultrasonography and CT findings of intramural hematomas might imitate massive formations [3].…”

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confidence: 99%

CT findings of Intramural Small Bowel Hematoma Secondary to use of Oral Anticoagulant Therapy

Karadeli¹,

Tok²,

Erbay³

2016

Ann Clin Anal Med

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" [1] presented by İbrahim Yetim and colleagues in your journal. We wanted to mention a case diagnosed by clinical, laboratory and CT findings and treated non-surgically that might contribute to the valuable article. Oral anticoagulants are used for reasons like atrial fibrillation and venous thrombosis. One small intestinal hematoma was reported in 2500 cases using oral anticoagulants [2]. Ultrasonography and CT findings of intramural hematomas might imitate massive formations [3]. The patient history and INR levels are important for the diagnosis. The diagnosis can be confirmed by endoscopic biopsies [4]. In the treatment, hemostasis is obtained and the regression of the hematoma is monitored. Rarely, surgery is needed. In literature, surgery has been performed in cases where spontaneous regression does not occur or necrosis or peritonitis develops and if the diagnosis is unclear [4]. The 55 year old female case presented with a 3 day history of diffuse abdominal pain and no gas or stool passage. She had been using Coumadin after an ASD operation for atrial fibrillation. Physical examination revealed diffuse abdominal defense. The laboratory test results were high, APTT was 93.70 sec, PT was 111.30 sec and INR was 15.96. In the CT scans with and without contrast, thickening of the intestinal wall was observed in the pelvic region and the mean density was measured 50HU in the scan without contrast and 55HU in the contrasted scan [ figure 1]. In the proximal of the intestines defined, diffuse dilatation consistent with ileus was identified. A minimal degree of free fluid was observed. The SMA and SMV were intact in the contrasted images. With consideration of the patient's INR values the findings were primarily regarded in favor of an intramural hematoma. Coumadin was stopped and a heparin infusion was started. After the INR levels and abdominal complaints resolved the Coumadin treatment was continued. In the CT scans obtained, regression of the intramural thickness and dilatation of the small intestines was noted [ figure 2]. As a conclusion, the diagnosis of intramural hemorrhage can be made according to the clinical, laboratory and radiologic findings. In the following, INR levels and ultrasound and CT findings are important. Ultrasonography is noninvasive, so it may be first prefer in the following. The treatment can be stopping coumadin treatment and performing surgery if the situation does not resolve depending on the clinical picture.

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Colon Obstruction due to an Anticoagulant Induced Intramural Haematoma- A Rare Case Report

Cited by 16 publications

References 4 publications

A Rare Complication of Anticoagulant Use: Colonic Intramural Hematoma-Case Report

A Rare Complication of Anticoagulant Use: Colonic Intramural Hematoma-Case Report

Supportive Management Resolved a Colonic Intramural Hematoma in an Anticoagulant User

CT findings of Intramural Small Bowel Hematoma Secondary to use of Oral Anticoagulant Therapy

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