Intramural hematomas of the small bowel (duodenum excluded) during long-term anticoagulant treatment. Report on 6 cases of which 2 required operation
Vinard, J.L.; Bouchet, C.; Aubert, H.; Meullenet, J.; Ohanessian, J.H.; Aubert, M.; Latreille, R.
Journal de Chirurgie 118(5): 307-314
1981
ISSN/ISBN: 0021-7697 PMID: 7251695 Document Number: 174961
Hematomas developed in the small bowel of 6 patients receiving long-term anticoagulant therapy with antivitamins K. As the report by Chapuis and Mercier during the 81st French Congress of Surgery has fully covered this subject, the authors present their cases to illustrate their clinical features, while emphasizing certain particular characteristics: 1 - Associated hemorrhagic lesions were frequently observed. 2 - Early diagnostic follow-through barium meal examinations of the small intestine could be conducted without any particular problem. 3 - Laparotomy was necessary in two patients because of shock or local signs on examination. 4 - Small bowel lesions can vary in severity, sometimes in the same patient (case no 1). Some hematomas heal spontaneously after discontinuation of anticoagulant treatment, while others can, theoretically, develop necrotic reactions. Small bowel resection was necessary in two patients. 5 - A frequent occurrence was the association of lesions in the right colic and ileal regions. 6 - Finally, anticoagulant treatment can often be reduced, discontinued, or replaced by other therapy.