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

Samie, Ahmed Abdel; Sun, Rui; Huber, Andreas; Höpfner, W; Theilmann, Lorenz

doi:10.1007/s00063-012-0184-0

Cited by 22 publications

(11 citation statements)

References 17 publications

(22 reference statements)

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“…In 1967, Killian and Heitzman [11] included intramural small bowel hematoma in the differential diagnosis of acute abdomen in cases when the patient is under anticoagulant therapy. More recently published papers state that it should be considered in any anticoagulated patient with abdominal complaints [6] , [7] , which can vary from mild and vague to intestinal obstruction or an acute abdomen [12] .…”

Section: Discussionmentioning

confidence: 99%

“…Presently, the best accepted imaging method to evaluate anticoagulated patients at risk of bleeding is multidetector computed tomography (MDCT) [12] , [13] . The signs to look for and which enable differential diagnosis with a tumour or inflammatory bowel disease include symmetric bowel thickening, with high attenuation in its acute phase, associated with some luminal narrowing.…”

Section: Discussionmentioning

confidence: 99%

“…Other supportive measures should be instituted according to patients’ needs [4] , [5] . However, surgical management could still be considered in cases where intestinal ischemia or perforation, peritonitis, intra-abdominal haemorrhage and refractory GI blockages persist [4] , [12] . In this case, there was no call for surgery as the patient did not present with any of the above-mentioned complications.…”

Section: Discussionmentioning

confidence: 99%

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Overlooked complication of anticoagulant therapy: The intramural small bowel hematoma—A case report

Pimenta

Saramet

Castro

et al. 2017

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Overlooked complication of anticoagulant therapy: The intramural small bowel hematoma—A case report

Pimenta

Saramet

Castro

et al. 2017

International Journal of Surgery Case Reports

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“…Holding anticoagulant, reversing anticoagulation, close monitoring and observation will be enough in management of most SISBH cases [ 11 ]. Surgery should be reserved for cases with uncertain diagnosis or complications like intra-abdominal hemorrhage, perforation, peritonitis, and intestinal obstruction not responding to conservative treatment [ 12 ]. Our patient was monitored closely and reversal of anticoagulation was enough for successful treatment.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

Günaydın¹,

Sivri²,

Sivri

et al. 2015

Case Reports in Emergency Medicine

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Introduction. We present a case of concurrent spontaneous sublingual and intramural small bowel hematoma due to warfarin anticoagulation. Case. A 71-year-old man presented to the emergency department complaining of a swollen, painful tongue. He was on warfarin therapy. Physical examination revealed sublingual hematoma. His international normalized ratio was 11.9. The computed tomography scan of the neck demonstrated sublingual hematoma. He was admitted to emergency department observation unit, monitored closely; anticoagulation was reversed with fresh frozen plasma and vitamin K. 26 hours after his arrival to the emergency department, his abdominal pain and melena started. His abdomen tomography demonstrated intestinal submucosal hemorrhage in the ileum. He was admitted to surgical floor, monitored closely, and discharged on day 4. Conclusion. Since the patient did not have airway compromise holding anticoagulant, reversing anticoagulation, close monitoring and observation were enough for management of both sublingual and spontaneous intramural small bowel hematoma.

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“…[14–19] This is the first case of MD with recurrent spontaneous subserosal hematoma of ileum, which induced intestinal obstruction.…”

Section: Introductionmentioning

confidence: 99%

Recurrent spontaneous subserosal hematoma of ileum causing intestinal obstruction in a patient with menkes disease

Weng¹,

Hsu²,

Wang³

et al. 2016

Medicine

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Background:Menkes disease (MD) is a disorder of copper metabolism due to ATP7A gene mutation that leads to severe copper deficiency. Deformed blood vessels can be found in many parts of the body, and intracranial hematoma is generally reported.Methods:We report a Taiwanese boy with MD who had recurrent spontaneous subserosal hematoma of ileum presenting as intestinal obstruction, with the 2 episodes 23 months apart. The patient returned to the usual physical status after surgical removal of the hematoma.Results:The defective copper metabolism causes dysfunction of a plenty of copper-dependent enzymes, giving rise to unique kinky hair appearance, progressive neurodegeneration, and connective tissue abnormalities. To our knowledge, this is the first report on recurrent subserosal hemorrhage of intestine in MD.Conclusion:Owing to the fragile structure of blood vessels, subserosal hematoma should be considered when patients with MD having intestinal obstruction.

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

Cited by 22 publications

References 17 publications

Overlooked complication of anticoagulant therapy: The intramural small bowel hematoma—A case report

Overlooked complication of anticoagulant therapy: The intramural small bowel hematoma—A case report

Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

Recurrent spontaneous subserosal hematoma of ileum causing intestinal obstruction in a patient with menkes disease

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