Cecal Intramural Hematoma after Acupuncture in a Patient Taking Anticoagulant Drug

Lee, Yoon Suk; Kim, Jin Jo; Lee, Keun Ho; Oh, Se Jung; Park, Seung Man; Kim, Young Ha

Abstract

The most common causes of an intramural hematoma of the bowel are blunt trauma and complications from an anticoagulant drug. The duodenum is the most common site of an intramural hematoma caused by blunt trauma. An intramural hematoma caused by the use of an anticoagulant drug commonly involves the small bowel and can be conservatively treated with good prognosis. However, an intramural hematoma caused by trauma or injury in a patient who is taking an anticogulant drug has rarely been reported. We report the case of 75-year-old woman with an intramural hematoma who took cumadin after acupuncture and who presented with acute abdominal pain, especially on the RLQ area. Abdominal CT showed a cecal wall enlargment and enhancement. We performed an emergency operation under the impression of peritonitis. During the opertion, we found the cecal intramural hematoma, so a right hemicolectomy was done. An Intramural hematoma after a focal injury, such as acupuncture, in a patient who is taking an anticoagulant drug can take place in Korea. We think that proper treatment should be studied. Also education patients taking an anticoagulant drug should be addressed.