Alberto Sara Folgado, Sánchez Paula, Felix Julieta, Deus João Ramos
Departamento de Gastroenterología, Hospital Fernando Fonseca, Amadora, Lisboa, Portugal.
Gastroenterol Hepatol. 2009 May;32(5):346-8. doi: 10.1016/j.gastrohep.2008.12.005. Epub 2009 May 12.
Intramural hematoma of the small bowel is an infrequent complication of the use of oral anticoagulants. Diagnosis can only be performed when these symptoms are associated with a history of oral anticoagulant use and radiological tests. We report the case of a patient admitted for epigastric pain associated with oral anticoagulation therapy with warfarin and a 48-h history of retention vomiting. Ultrasound and abdominal computed tomography scans revealed a jejunal loop with diffuse parietal thickening, suggesting an intramural hematoma. Conservative therapy was provided with symptomatic regression on the second day and reabsorption of the jejunal intramural hematoma. Anticoagulation therapy was reintroduced with no recurrences.
小肠壁内血肿是口服抗凝剂使用中罕见的并发症。只有当这些症状与口服抗凝剂使用史及放射学检查相关时才能做出诊断。我们报告一例患者,因华法林口服抗凝治疗相关的上腹部疼痛及48小时的持续性呕吐入院。超声和腹部计算机断层扫描显示一段空肠肠袢伴有弥漫性肠壁增厚,提示壁内血肿。给予保守治疗,第二天症状消退,空肠壁内血肿吸收。重新开始抗凝治疗后未再复发。