Coumarin-induced intramural hematoma of the duodenum: Case report and review of the literature

Abstract

Objective. Intramural hematoma of the small intestine is a complication of anticoagulant treatment with an estimated incidence of 1 case per 2500 anticoagulated patients per year. Patients may present with signs of small bowel obstruction or, in case of a ruptured hematoma, with upper gastrointestinal tract hemorrhage and hypovolemic shock. Material and methods. Case report and review of the literature. Results. We present a case of a 73-year-old male who was referred for a protruding mass in the duodenum and subsequently developed hematemesis and melena caused by a ruptured hematoma of the duodenal wall. Conclusions. Although intramural hematoma of the duodenum is a rare complication of anticoagulant therapy, early diagnosis with subsequent correction of coagulation parameters is of vital importance.

Key Words::

• Anticoagulants
• coumarins
• duodenum
• gastroduodenal-clinical
• GI-bleeding
• hematoma

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.