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Sonographic diagnosis of spontaneous intramural small bowel hematoma in a case of warfarin overdose

✍ Scribed by Sheng-Wen Hou; Chien-Chih Chen; Kuo-Chih Chen; Shih-Yu Ko; Chung-Shun Wong; Chee-Fah Chong

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
120 KB
Volume
36
Category
Article
ISSN
0091-2751

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✦ Synopsis

Abstract

A 38‐year‐old man who had been treated with warfarin since mitral valve replacement 10 years earlier presented with acute onset of epigastralgia and melena. Coagulation tests were abnormal with a prolonged prothrombin time of >60 seconds and a prolonged activated partial thromboplastin time of >120 seconds. Abdominal sonographic examination revealed duodenal intramural hematoma that was confirmed on CT. Warfarin therapy was stopped and the patient was treated conservatively with vitamin K and fresh frozen plasma. Recovery was uneventful, and the patient was re‐warfarinized 2 weeks later. Duodenal hematoma can be readily diagnosed with bedside sonography. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.

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