An unusual cause of abdominal pain.
A 36-year-old woman presented to the Emergency Room because of abdominal pain associated with hematuria and red blood blending to stool. On admission, the physical examination revealed abdominal tenderness and diffuse cutaneous hematoma. The laboratory findings showed abnormal clotting tests with high International Normalised Ratio (INR) and prolonged activated partial thromboplastin time. Hemoperitoneum and ureteral hematoma were noted on the abdomen computed tomography. The patient confessed she had ingested difenacoum for several weeks. All the symptoms resolved with fresh frozen plasma perfusion and vitamin K.
Terneu
S
S
Department of Intensive Care and Emergency Medicine, Cliniques Universitaires Saint Luc, 1200 Brussels, Belgium.
Verhelst
D
D
Thys
F
F
Ketelslegers
E
E
Hantson
P
P
Wittebole
X
X
D015110:4-Hydroxycoumarins / Q000506:poisoning*; D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D018570:Risk Assessment; D012720:Severity of Illness Index; D013406:Suicide, Attempted; D014057:Tomography, X-Ray Computed; D014567:Urography / Q000379:methods
D015110:4-Hydroxycoumarins; C012903:difenacoum