phenprocoumon and Duodenal-Diseases

Spontaneous small-bowel hematomas most commonly involve the jejunum, followed by the ileum and duodenum, and occur in patients who receive excessive anticoagulation with phenprocoumon/warfarin or who have additional risk factors for bleeding. We report three cases of intramural small-bowel hematoma, all complications of treatment with phenprocoumon, which nowadays is used extensively for therapeutic and prophylactic purposes. Diagnosis can be readily attained by sonography and confirmed using computed tomography. Early diagnosis is crucial because most patients can be treated successfully without surgery. Based on this experience and data from the literature, conservative treatment is recommended for intramural intestinal hematomas, when other complications needing laparotomy have been excluded.

Topics: Aged, 80 and over; Anticoagulants; Atrial Fibrillation; Cholangiopancreatography, Endoscopic Retrograde; Duodenal Diseases; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Image Enhancement; Intestine, Small; Jejunal Diseases; Magnetic Resonance Imaging; Male; Phenprocoumon; Tomography, X-Ray Computed; Ultrasonography

Topics: Aged, 80 and over; Anticoagulants; Duodenal Diseases; Female; Hematoma; Humans; Jaundice, Obstructive; Magnetic Resonance Imaging; Phenprocoumon; Tomography, X-Ray Computed; Ultrasonography

We report the history of a 68-year-old man who has been hospitalized for an aortic valve endocarditis. The patient was under full anticoagulation therapy because of an artificial aortic valve (Omnicarbon 23 mm). During hospitalization the patient developed a subacute abdomen accompanied by upper gastrointestinal tract hemorrhage. At endoscopy and radiology an intramural hematoma of the duodenum was found. The typical findings of intramural hematoma such as abdominal X-ray, ultrasound, CT scan, selective small bowel transit and endoscopy are presented and the history as well as therapeutic modalities discussed.

Topics: 4-Hydroxycoumarins; Aged; Aortic Valve; Duodenal Diseases; Gastrointestinal Hemorrhage; Heart Valve Prosthesis; Hematoma; Humans; Male; Phenprocoumon

We report a case of intramural haemorrhage in the duodenum, which was diagnosed by endoscopy and clinical findings. The typical endoscopic findings are described and illustrated. Different causes of intramural haemorrhage of the gut are discussed.

Topics: 4-Hydroxycoumarins; Duodenal Diseases; Endoscopy; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Phenprocoumon

Topics: Aged; Anticoagulants; Duodenal Diseases; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Middle Aged; Phenprocoumon