Intramural jejunal hematomas secondary to anti-coagulant therapy

Anticoagulant therapy and the acute abdomen

“…The features to look for on plain radiographs are the presence of multiple dilated loops of bowel with fluid levels, a generalized haziness of films due to the haemoperitoneum, and the presence of a 'thick bowel' sign (Silbert, Figiel, and Figiel, 1962;Sears, Hawkins, Kilgore, and Miller, 1964). Barium studies are very helpful, and demonstrate a rigid, narrowed segment of bowel with an intact, coarsened mucosal pattern (Culver and others, 1961; Senturia and others, 1961).…”

A retrospective review of patients with non-traumatic spontaneous intramural hematoma

“…In abdominal radiographies, findings suggestive of intestinal obstruction (gastric dilatation and/or an air-fluid level) may be found, while these findings are non-specific and may suggest the possibility of IMH only if it is known that the patient uses anticoagulants (15). Several appearance features were defined, which can be found in a majority of IMH cases using barium-enhanced radiography (16,17). However, none of these findings are specific.…”

Intramural gastrointestinal hemorrhage

“…The bowel sounds are hypoactive or absent and abdominal tenderness may be present. With few exceptions, the c o m m o n denominator in all patients is the rapid clinical remission with conservative management and the absence of any clinical sequelae [6,7,16,34]. Previously, such patients were unnecessarily explored and needless small bowel resections carried out [30].…”

“…The rapid improvement of the radiographic configuration is highly specific after a short period of time [16,17,23]. We believe, however, that certain generalizations can be made: The scout abdominal examination, although occasionally helpful, is unreliable or at least unpredictable.…”