Acute pancreatitis complicated by jejunal hematoma in a patient on anti-coagulants and anti-platelets.
BACKGROUND
Pancreatitis can be associated with significant complications. Bowel hematoma is a rare complication and the second part of the duodenum is the most commonly affected site. Hematomas affecting other parts of the bowel are extremely rare.


METHODS
A 53-year-old female with a history of atrial fibrillation and ischemic heart disease on anticoagulants and aspirin presented with abdominal pain of a few days duration which had worsened prior to presentation. This was associated with abdominal distension, vomiting and melena. Laboratory investigations showed elevated serum amylase, coagulopathy and severe anemia. Computed tomography imaging showed a jejunal hematoma and pancreatitis with peripancreatic inflammation. She responded to conservative treatment in addition to correction of the coagulopathy and a blood transfusion. Her symptoms were resolved within a few days and a repeat computed tomography scan two months later showed complete resolution of the hematoma and the pancreatitis.


CONCLUSIONS
Our case demonstrates a rare complication of acute pancreatitis in a patient with risk factors.
Chong
Vui Heng
VH
Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam. chongvuih@yahoo.co.uk
Basir
Norwani
N
Yaakub
Aziman Bin
AB
D000208:Acute Disease; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000139:chemically induced / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007583:Jejunum / Q000098:blood supply / Q000000981:diagnostic imaging; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin