title: Anticoagulant-induced intramural intestinal hematoma.
abstract: Intramural hematoma of the intestine is a rare complication of anticoagulant therapy. We evaluated 7 nontrauma patients with intramural hematoma of the intestine diagnosed at our institution between May 1998 and June 2001. All of the patients were receiving long-term anticoagulant therapy for previous diseases. All 7 patients had abdominal pain, 6 had additional symptoms of nausea and vomiting, and 4 had melanotic stools at admission. Six of the patients had abnormal coagulation parameters. Both abdominal ultrasonography (US) and computerized tomography (CT) showed the exact pathology in all patients. Five of the 7 patients were treated, nonoperatively, and the other patients underwent surgery. All of the patients were followed with abdominal US and CT (mean 12 = months), with complete resolution of their intramural hematomas. Abdominal US and CT evaluation performed together will help the accuracy of diagnosis of intramural hematoma, but nonoperative therapy is the treatment of choice, with surgery indicated if generalized peritonitis or intestinal obstruction develops.
authors.affiliation: Department of Surgery, Ondokuz Mayis University, School of Medicine, Samsun, Turkey.
authors.forename: Cafer
authors.initials: C
authors.lastname: Polat
authors.forename: Adem
authors.initials: A
authors.lastname: Dervisoglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Guven
authors.forename: Ekrem
authors.initials: E
authors.lastname: Kaya
authors.forename: Zafer
authors.initials: Z
authors.lastname: Malazgirt
authors.forename: Murat
authors.initials: M
authors.lastname: Danaci
authors.forename: Kayhan
authors.initials: K
authors.lastname: Ozkan
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000006:Abdomen, Acute / Q000175:diagnosis; D015746:Abdominal Pain / Q000139:chemically induced; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000506:poisoning*; D003937:Diagnosis, Differential; D062787:Drug Overdose / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D016896:Treatment Outcome; D014463:Ultrasonography; D014859:Warfarin / Q000506:poisoning*
chemical_list: D000925:Anticoagulants; D014859:Warfarin