Warfarin-induced small bowel obstruction.
We present a rare case of small bowel obstruction in a patient on long-term anticoagulation. A 53-year woman presented with abdominal pain and vomiting. She was on warfarin following aortic and mitral valve surgery. A small bowel follow through revealed jejunal narrowing consistent with a stricture. This probably was the result of submucosal bleeding because of over warfarinazation. The warfarin was stopped and she started on heparin with complete resolution of symptoms. This rare complication of anticoagulation should be considered in patients on warfarin. Early diagnosis is crucial as most patients are treated conservatively with very few patients requiring surgery.
Manu
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N
Royal Liverpool University Hospital, Liverpool, UK. nayarmanu@hotmail.com
Martin
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L
D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007415:Intestinal Obstruction / Q000139:chemically induced* / Q000175:diagnosis; D007421:Intestine, Small / Q000473:pathology*; D008875:Middle Aged; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects*
D014859:Warfarin; D006493:Heparin