title: Hemorrhagic Shock as Complication of Intramural Intestinal Bleeding.
abstract: Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality.Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma. Medical treatment was sufficient and there was no need for surgery.Conclusion. Gastrointestinal bleeding associated with shock in patients treated by oral anticoagulant should alert physicians to research a probable MIH. Urgent diagnosis and appropriate medical treatment can avoid surgical interventions.
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Asma
authors.identifier: 0000-0003-2413-8760
authors.initials: A
authors.lastname: Ben Ali
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Mohamed Ali
authors.initials: MA
authors.lastname: Cherif
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Walid
authors.initials: W
authors.lastname: Mhajba
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Hamdi Hamdène
authors.initials: HH
authors.lastname: Doghri
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Malek
authors.initials: M
authors.lastname: Hassouna
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Youssef Zied El
authors.initials: YZ
authors.lastname: Hechmi
authors.affiliation: Emergency Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Zouheir
authors.initials: Z
authors.lastname: Jerbi
authors.affiliation: Radiology Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Ines
authors.initials: I
authors.lastname: Ben Hassen
authors.affiliation: Radiology Department, Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Mohamed Habib
authors.initials: MH
authors.lastname: Daghfous