Case Report

A Rare Cause of Acute Abdomen Due to Warfarin Toxicity: Spontan Intramural Intestinal Hematoma


  • Zafer Kılbaş
  • Ali Harlak
  • Nail Ersöz
  • İsmail Hakkı Özerhan
  • Öner Menteş
  • Mehmet Eryılmaz

Received Date: 19.12.2008 Accepted Date: 09.02.2009 Eurasian J Emerg Med 2009;8(4):43-45

In the present study, it is aimed to report two cases of spontaneous intramural intestinal hematoma caused by anticoagulant overdose. A 79-year-old man and a 63-year-old woman were admitted to emergency unit with the signs and symptoms of acute intestinal obstruction. The patients had the history of warfarin usage. Physical examination showed diffuse abdominal distension and tenderness without rigidity. Both of the patients had abnormal coagulation parameters with a prolonged prothrombin time and INR value. Computed tomography of the abdomen revealed thickening of the jejunum wall. Patients were managed with bowel rest and with the supply of fresh frozen plasma and vitamin K. They were discharged after an uneventful recovery. In patients presenting with the clinics of acute abdomen and with the history of warfarin therapy, the rare intraabdominal complications of oral anticoagulants should be known by clinicians, dealing with emergency medicine, in order to avoid an unnecessary operation.

Keywords: Intramural hematoma; small bowel, oral anticoagulant