Spontaneous Intramural Small Bowel Hematoma Induced by Anticoagulant Therapy: Review and Case Report

Abstract

CLINICS 2007;62(6):785-90 Spontaneous intramural small bowel hematoma induced by anticoagulant therapy Sorbello MP et al. CLINICS 2007;62(6):785-90 Spontaneous intramural small bowel hematoma induced by anticoagulant therapy Sorbello MP et al.

MR imaging findings of small bowel hemorrhage: Two cases of mural involvement and one of perimural

“…This concurs with reports in the literature that generally describe the occurrence of bowel hemorrhage in the small intestine (2,6). This has been considered to reflect the rich vascularity of the small intestine in comparison to the large intestine (7).…”

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

“…Better et al reported an incidence of 1 in 2,500 patients receiving warfarin [10]. The incidence is higher in males and the average age at presentation is 57.6 years [9].…”

“…Some authors have suggested that noncontrast CT should be performed before oral and intravenous contrast medium application, as contrast-enhanced CT alone may mask the presence of intramural hemorrhage [9]. Characteristic findings on CT include circumferential wall thickening, intramural hyperdensity, luminal narrowing, and intestinal obstruction [7,15].…”

“…Surgical exploration is reserved for cases with uncertain diagnosis or late complications, which include intra-abdominal hemorrhage, suspec ted ischemia, perforation, peritonitis, and intestinal obstruction not responding to conservative strategies [9,10,14,22].…”

“…Nontraumatic spontaneous intramural small-bowel hematoma, once considered a rare complication of anticoagulation, is being reported with increasing frequency [7,8,9]. The incidence of this clinical entity is predicted to further increase as a result of the wide use of long-term anticoagulation in an aging population.…”