Risk factors and management of anticoagulant-induced intramural hematoma of the gastrointestinal tract

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
A Abdel Samie, L Theilmann

Abstract

Intramural intestinal hematoma is considered a rare complication of overanticoagulation in elderly patients. Nevertheless, this clinical entity is increasingly being reported in the literature, and its incidence is predicted to increase further as a result of the wide use of long-term anticoagulation in an aging population. However, data regarding the risk factors and optimal management of this unusual complication in patients on phenprocoumon/warfarin are scarce. We retrospectively analyzed the medical reports of patients with intramural gastrointestinal hematoma on anticoagulant therapy who were treated in our unit between January 2008 and July 2011. Four consecutive patients were identified during the study period. The mean age of the patients was 80 years. All patients were on uninterrupted anticoagulation with phenprocoumon due to chronic atrial fibrillation. Hematoma was localized in the duodenum in one patient, in the jejunum in two patients, and in the rectum in one patient. Hematoma occurred spontaneously in three patients and following a trauma in one patient. Excessive anticoagulation with an INR of >6 was associated with the development of this complication in all spontaneous cases. A combination of computed tomogra...Continue Reading

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Citations

Mar 19, 2014·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·H TirumaniN H Ramaiya
Oct 1, 2016·International Journal of Surgery Case Reports·Sanne Jensen Dich, Alaa El-Hussuna

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