[Skip to Content]
[Skip to Content Landing]
Article
February 1964

Intramural Small Bowel Bleeding During Anticoagulant Therapy

Author Affiliations
PALO ALTO, CALIF
Department of Radiology (Dr. Kramer) and Department of Internal Medicine (Dr. Hill), Palo Alto Medical Clinic.
Arch Intern Med. 1964;113(2):213-217. doi:10.1001/archinte.1964.00280080049010
Abstract

Introduction  Intramural hematoma of the small bowel may occur as a complication of anticoagulant therapy. A variety of clinical pictures may result from the intramural accumulation of blood in the intestine, often resembling peptic disease or intestinal obstruction. The rather characteristic radiographic appearance is valuable in establishing the diagnosis. The following two cases illustrate the clinical and roentgenologic features of the entity.

Report of Cases 

Case 1.  —A 58-year-old Caucasian male was admitted to the Palo Alto-Stanford Hospital for the second time, on Aug 1, 1961, complaining of midepigastric pain of about 48 hours' duration, with hematemesis three times during the previous 12 hours. The patient had been previously hospitalized in September, 1960, with myocardial infarction and had been on maintenance anticoagulant therapy since that time. The details of the anticoagulant dosage were not available at the time of entry.The patient appeared to be in moderate discomfort. His blood

References
1.
Spencer, R.; Bateman, J. D.; and Horn, P. L.:  Intramural Hematoma of the Intestine, a Rare Cause of Intestinal Obstruction: Review of the Literature and Report of a Case ,  Surgery 41:794, 1957.
2.
Berman, H., and Mainella, F. S.:  Toxic Results of Anticoagulant Therapy ,  New York J Med 52:725, 1952.
3.
Senturia, H. R.; Sussman, N.; and Shyken, H.:  The Roentgen Appearance of Spontaneous Intramural Hemorrhage of the Small Intestine Associated With Anticoagulant Therapy ,  Amer J Roentgen 86:62, 1961.
4.
Wiot, J. F.; Weinstein, A. S.; and Felson, B.:  Duodenal Hematoma Induced by Coumarin ,  Amer J Roentgen 86:70, 1961.
5.
Beamish, R. E., and McCreath, N. D.:  Intestinal Obstruction Complicating Anticoagulant Therapy ,  Lancet 2:390, 1961.Crossref
6.
Hafner, D.; Cranley, J. J.; Krause, R. J.; and Strasser, E. S.:  Anticoagulant Ileus ,  JAMA 182: 947, 1962.Crossref
7.
Felson, B., and Levin, E. J.:  Intramural Hematoma of the Duodenum: Diagnostic Roentgen Sign ,  Radiology 62:823, 1954.
×