title: A retrospective review of patients with non-traumatic spontaneous intramural hematoma.
abstract: OBJECTIVE
  Non-traumatic spontaneous intramural hematoma of the small intestine is a rare clinical condition, most commonly caused by over-anticoagulation. In this study, the clinical approach algorithm for patients diagnosed with a spontaneous isolated intramural hematoma of the small intestine associated with over-anticoagulation and the long-term outcomes of the patients are presented.
  
  
  METHODS
  The records of patients who were diagnosed with intramural hematoma in 3 different medical faculty hospitals between 2007 and 2011 were retrospectively analyzed. After excluding patients with trauma history, hematoma in organs other than the small intestine, and with etiological factors other than over-anticoagulation, 15 patients with an isolated intramural hematoma of the small intestine were evaluated within the scope of the study.
  
  
  RESULTS
  The sites of first admission were emergency departments for 10 patients (66.6%) and other clinics for 5 patients (33.3%). Thirteen patients (86.6%) received medical treatment and two patients (13.3%) underwent surgical treatment. During the hospitalization period, a total of two patients (13.3%) died. Out of the 11 patients with an average follow-up of 22 months (range: 4-48 months), no patient had a relapseof intramural hematoma and three patients (27.7%) died due to reasons not related to intramural hematoma.
  
  
  CONCLUSIONS
  Intramural hematoma diagnosis should be known by all physicians, because the site of first admission may be different clinics, since the clinical presentation begins with non-specific complaints. Early and accurate diagnosis by non-invasive methods will preclude unnecessary surgical interventions.
authors.affiliation: Sakarya University Faculty of Medicine, Department of General Surgery, Sakarya, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Altintoprak
authors.forename: Enis
authors.initials: E
authors.lastname: Dıkıcıer
authors.forename: Muhammed
authors.initials: M
authors.lastname: Akyüz
authors.forename: Uğur
authors.initials: U
authors.lastname: Devecı
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Arslan
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Gündüz
authors.forename: Murat
authors.initials: M
authors.lastname: Yücel
authors.forename: Osman Nuri
authors.initials: ON
authors.lastname: Dılek
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis*; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000925:Anticoagulants