Korean J Med.
2010 Nov;79(5):518-525.
Clinical characteristics of spontaneous intestinal intramural hematoma: a single-center experience
- Affiliations
-
- 1Department of Internal Medicine, Kepco Medical Foundation, Hanil General Hospital, Seoul, Korea.
- 2Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jsbyeon@amc.seoul.kr
- 3Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
- BACKGROUND/AIMS
Spontaneous intestinal intramural hematoma is a rare complication occurring most commonly in patients receiving anticoagulant therapy. The present study aimed to analyze the clinical features and prognosis of this condition.
METHODS
We retrospectively analyzed the medical records of 14 patients who were diagnosed with spontaneous intestinal intramural hematoma based on characteristic computed tomography findings and treated for this condition at Asan Medical Center from March 2001 to February 2009.
RESULTS
The median age of patients was 67 years. All patients were receiving anticoagulant therapy. The most common presenting symptoms were abdominal pain (14 patients), nausea/vomiting (9 patients), and melena/hematochezia (8 patients). The median international normalized ratio (INR) was 7.7 (1.6- >15.1). The INR was above 3.5 in 13 patients (93%). Hematomas most commonly involved the jejunum (7 patients), followed by the ileum (4 patients). All patients rapidly recovered without short-term complications after medical treatment, including correction of coagulation abnormalities. Twelve patients resumed anticoagulant therapy after symptomatic resolution and correction of coagulation abnormalities, and no complications, including rebleeding, occurred during the mean 37.4 months of follow-up.
CONCLUSIONS
Spontaneous intestinal intramural hematoma rapidly improved after medical treatment, and no complications occurred. It may be safe to carefully resume anticoagulant therapy in patients at high risk of thromboembolism.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Jejunal Intramural Hematoma with Bowel Obstruction in a 5-year-old Boy: A Case Report
- Spontaneous Intramural Intestinal Hematoma: A Rare Complication of Anticoagulation
- A Case of Anticoagulant-induced Spontaneous Intramural Intestinal Hematoma
- A Case of Warfarin-Induced Intramural Hematoma Diagnosed by Double-Balloon Enteroscopy
- A Case of Spontaneous Intramural Hematoma of the Esophagus
