title: Spontaneous intramural small-bowel hematoma secondary to anticoagulant therapy: a case series.
abstract: Spontaneous small-bowel hematomas most commonly involve the jejunum, followed by the ileum and duodenum, and occur in patients who receive excessive anticoagulation with phenprocoumon/warfarin or who have additional risk factors for bleeding. We report three cases of intramural small-bowel hematoma, all complications of treatment with phenprocoumon, which nowadays is used extensively for therapeutic and prophylactic purposes. Diagnosis can be readily attained by sonography and confirmed using computed tomography. Early diagnosis is crucial because most patients can be treated successfully without surgery. Based on this experience and data from the literature, conservative treatment is recommended for intramural intestinal hematomas, when other complications needing laparotomy have been excluded.
authors.affiliation: Department of Gastroenterology, Pforzheim Hospital. abdelsamie@ngi.de
authors.forename: A
authors.initials: A
authors.lastname: Abdel Samie
authors.forename: R
authors.initials: R
authors.lastname: Sun
authors.forename: A
authors.initials: A
authors.lastname: Huber
authors.forename: W
authors.initials: W
authors.lastname: Höpfner
authors.forename: L
authors.initials: L
authors.lastname: Theilmann
mesh_terms: D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004378:Duodenal Diseases / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007089:Image Enhancement; D007421:Intestine, Small; D007579:Jejunal Diseases / Q000139:chemically induced / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D010644:Phenprocoumon / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000925:Anticoagulants; D010644:Phenprocoumon