title: Anticoagulation-induced spontaneous intramural small bowel haematomas.
abstract: Small intestinal intramural haematomas may develop spontaneously, especially in patients with deranged clotting function. We present a case of a 57-year-old man who developed abdominal pain in the setting of abnormal clotting function secondary to an inadvertent warfarin overdose. A CT scan showed thickening of parts of the distal ileum, terminal ileum and duodenum. Dilation of the small bowel proximal to the thickening was also reported, indicative of a degree of small bowel obstruction. The patient was treated conservatively with a nasogastric tube and intravenous fluids. His anticoagulation was fully reversed with fresh frozen plasma and vitamin K. The patient remained well 6 months following discharge, with well-controlled anticoagulation levels and resolution of the findings on CT.
authors.affiliation: Department of Surgery, Mater Dei Hospital, Malta, Msida, Malta. a.zammit.12@ucl.ac.uk
authors.forename: Adrian
authors.initials: A
authors.lastname: Zammit
authors.forename: Deborah Grech
authors.initials: DG
authors.lastname: Marguerat
authors.forename: Clifford
authors.initials: C
authors.lastname: Caruana
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D006406:Hematoma / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D000925:Anticoagulants