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华法林治疗继发肠壁内血肿导致的小肠梗阻:两例报告

Small bowel obstruction caused by intramural hematoma secondary to warfarin therapy: a report of two cases.

作者信息

Altikaya Naime, Parlakgümüş Alper, Demır Şenay, Alkan Özlem, Yildirim Tülin

机构信息

Başkent University, School of Medicine, Department of Radiology, Adana, Turkey.

出版信息

Turk J Gastroenterol. 2011;22(2):199-202. doi: 10.4318/tjg.2011.0192.

Abstract

Spontaneous intestinal hematoma is a rare complication of anticoagulant therapy, and small bowel obstruction caused by intramural hematoma secondary to anticoagulant therapy is even rarer. The first symptom is usually abdominal pain, frequently accompanied by nausea and vomiting. A history of anticoagulant use with prolonged international normalized ratios in patients presenting with abdominal pain should alert physicians to search for this entity. Typical findings on abdominal computed tomography yield the diagnosis. Early diagnosis is crucial because most patients are treated non-operatively with a good outcome. Herein, we present the non-enhanced and enhanced computed tomography findings of two cases who were admitted to the emergency clinic with acute abdominal pain and diagnosed as spontaneous intramural ileal hematomas and partial small bowel obstruction secondary to intramural ileal hemorrhage.

摘要

自发性肠血肿是抗凝治疗的一种罕见并发症,而抗凝治疗继发的壁内血肿导致的小肠梗阻则更为罕见。首发症状通常为腹痛,常伴有恶心和呕吐。在出现腹痛的患者中,有抗凝药物使用史且国际标准化比值延长,应提醒医生排查这种情况。腹部计算机断层扫描的典型表现可做出诊断。早期诊断至关重要,因为大多数患者采用非手术治疗,效果良好。在此,我们展示了两例因急性腹痛入住急诊诊所的患者的非增强和增强计算机断层扫描结果,这两例患者被诊断为自发性回肠壁内血肿以及回肠壁内出血继发的部分小肠梗阻。

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