Anticoagulation-induced spontaneous intramural small bowel haematomas.
Anticoagulation-induced spontaneous intramural small bowel haematomas.
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DOI：
10.1136/bcr-2013-008831
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发表时间：
2013-06-03
期刊：
影响因子：
0.9
通讯作者：
Caruana, Clifford
中科院分区：
文献类型：
--
作者：
Zammit, Adrian;Marguerat, Deborah Grech;Caruana, Clifford
小肠壁内血肿可自发发展，尤其是凝血功能紊乱的患者。我们报告一例57岁男性，因意外过量服用华法林而出现腹痛，继发于凝血功能异常。CT扫描显示回肠远端、回肠末端和十二指肠部分增厚。增厚近端的小肠扩张也有报道，表明有一定程度的肠梗阻。患者接受鼻胃管和静脉输液的保守治疗。他的抗凝被新鲜冰冻血浆和维生素K完全逆转。患者出院6个月后仍然很好，抗凝水平得到很好的控制，CT检查结果得到了很好的解决。
Small intestinal intramural haematomas may develop spontaneously, especially in patients with deranged clotting function. We present a case of a 57-year-old man who developed abdominal pain in the setting of abnormal clotting function secondary to an inadvertent warfarin overdose. A CT scan showed thickening of parts of the distal ileum, terminal ileum and duodenum. Dilation of the small bowel proximal to the thickening was also reported, indicative of a degree of small bowel obstruction. The patient was treated conservatively with a nasogastric tube and intravenous fluids. His anticoagulation was fully reversed with fresh frozen plasma and vitamin K. The patient remained well 6 months following discharge, with well-controlled anticoagulation levels and resolution of the findings on CT.