Spontaneous Intramural Small-Bowel Hematoma: A Rare Complication of Anticoagulant Therapy in an Elderly Patient

Abstract

Intramural hematoma of the small bowel is an infrequent complication of the use of oral anticoagulants. Here, we describe the case of a 74-year-old man who was undergoing anticoagulant therapy and presented with abdominal pain, nausea, vomiting, and a prolonged prothrombin time (INR > 8). Computed tomography of the abdomen showed a thickened small-bowel wall that involved efferent bowel loops. Exploratory laparotomy confirmed ecchymosis and edematous changes to several segments of the small bowel that resulted in obstruction. In conclusion, the incidence of this clinical entity is believed to be on the rise in the growing number of elderly patients currently on anticoagulant therapy, and physicians must keep this rare clinical entity in mind when treating patients.

Keywords

• anticoagulant
• complication
• intramuarl hematoma