Yeo JH, Terez C, Shapiro M, Merchant A. Warfarin Poisoning and Blunt Abdominal Trauma: A Rare Cause of Small Bowel Obstruction.
Cureus 2021;
13:e13603. [PMID:
33816002 PMCID:
PMC8009056 DOI:
10.7759/cureus.13603]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 02/28/2021] [Indexed: 11/23/2022] Open
Abstract
Intestinal intramural hematomas are a rare complication of blunt abdominal trauma in the setting of anticoagulation. A 52-year-old male presented to our surgical service with high-grade small bowel obstruction secondary to an extensive small bowel intramural hematoma requiring resection. The patient sustained a blunt abdominal assault several days earlier and workup revealed severe coagulopathy likely secondary to overexposure to a warfarin-based substance. Few cases have been reported on coagulopathic traumatic small bowel hematomas causing small bowel obstruction. Current literature suggests non-operative management can be used safely; however, operative intervention is warranted if there are signs of ischemia or perforation. This case highlights the importance of a high index of suspicion, thorough investigation, and prompt intervention to avoid significant morbidity in small bowel obstruction secondary to intramural traumatic hematoma.
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