warfarin and Abdomen--Acute

Acute renal artery embolism is an uncommon clinical diagnosis. We present a case report of a patient who was treated with transcatheter thrombolysis and a literature review and discussion of this condition and its management.

Topics: Abdomen, Acute; Acute Disease; Anticoagulants; Embolism; Fibrinolytic Agents; Heparin; Humans; Male; Middle Aged; Radiography; Renal Artery Obstruction; Thrombolytic Therapy; Tissue Plasminogen Activator; Treatment Outcome; Vascular Patency; Warfarin

Spontaneous intramural small-bowel hematoma (SISBH) is a rare complication of anticoagulation therapy. Presentation of SISBH can vary from mild abdominal pain to an acute abdomen.. A 70-year-old woman was brought to the emergency department because of severe abdominal pain for 1 day. She had a medical history of coronary artery disease and paroxysmal atrial fibrillation and was receiving anticoagulation therapy with warfarin for 3 years.. Computed tomography disclosed disproportional dilatation of the segmental small bowel and near-total obstruction of the intestinal lumen at the level of the jejunum, indicating an acute abdomen.. We performed laparoscopic exploration and found a segmental distal jejunum was tense, heavy, firm, and discolored with a blue hue. Histopathological examination of the resected jejunum revealed diffuse hemorrhage and necrosis at the mucosa and submucosal layers, indicating SISBH.. The patient had an uneventful recovery and was discharged in a relatively stable condition.. Warfarin-induced SISBH presenting as an acute abdomen is an emergency condition that needs early diagnosis and timely management. Surgical intervention may be indicated for intestinal obstruction, ischemia, perforation, peritonitis, and intra-abdominal hemorrhage.

Topics: Abdomen, Acute; Abdominal Pain; Aged; Anticoagulants; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Warfarin

Hematoma or abscess of the liver ligaments is extremely rare, and hematoma of the falciform ligament has been sporadically reported. We report the case of a 70-year-old female who presented with a three-day history of right upper quadrant abdominal pain, fever and nausea. With a preoperative diagnosis of probable perforated acalculous cholecystitis, the patient underwent emergency surgery. Hematoma of the falciform ligament was found. Wide excision of the falciform ligament including the hematoma with abscess was performed. Although pathology of the falciform ligament is rare, it should be included in the differential diagnosis of acute abdomen, especially in the case of antiaggregant drug usage.

Topics: Abdomen, Acute; Aged; Anticoagulants; Diagnosis, Differential; Female; Hematoma; Humans; Ligaments; Warfarin

This clinical study was conducted to present the clinical features, treatment and outcomes of rectus sheath hematoma (RSH), which is a complication of anticoagulation therapy that can present as acute abdomen.. Twenty-two spontaneous RSH cases who were on anticoagulation therapy were reviewed. Patient characteristics, anticoagulant therapy form and indications, clinical presentation, radiologic work-up, treatment modalities, recurrence, morbidity, and follow-up data were analyzed.. The majority of the patients were female (64%), and the mean age was 60.6 years. All of the patients (100%) were receiving at least one form of anticoagulation therapy; most (72%) were on warfarin therapy. History of coughing was found in 45% of the cases. The most common presenting signs and symptoms were abdominal pain and mass (77%). International normalized ratio (INR) was >3.0 in all patients on warfarin therapy. The diagnosis was made by abdominopelvic ultrasonography (US) and computerized tomography (CT). CT showed 100% sensitivity. The majority of patients (87%) were treated conservatively. Three patients (13%) were operated and 2 patients (9%) died as a result of RSH. Two patients experienced recurrence in one year.. RSH should be suspected in elderly, coughing patients on anticoagulation therapy, who present with clinical manifestations of acute abdomen. Early diagnosis can help to avoid increased morbidity or unnecessary surgical intervention.

Topics: Abdomen, Acute; Adult; Aged; Aged, 80 and over; Anticoagulants; Emergency Treatment; Female; Hematoma; Humans; Male; Middle Aged; Radiography; Rectal Diseases; Retrospective Studies; Turkey; Ultrasonography; Warfarin

Topics: Abdomen, Acute; Aged; Anticoagulants; Atrial Fibrillation; Gallbladder Diseases; Hemorrhage; Humans; Male; Necrosis; Warfarin

Warfarin-dependent spontaneous intramural hematoma of the small intestine is a rare complication. The first symptom is usually abdominal pain, frequently accompanied by nausea and vomiting. In some cases, concomitant gastrointestinal bleeding might be seen. Ultrasonography and computed tomography are the most useful radiographic methods for the diagnosis of an intramural hematoma of the intestines. Although it is usually treated conservatively, surgical intervention is required in cases involving active bleeding, intestinal obstruction, or acute abdominal symptoms. Here we present two patients who were treated surgically. Both patients had intestinal obstruction and ischemia, and one had concomitant gastrointestinal bleeding and intussusception due to an intramural hematoma.

Topics: Abdomen, Acute; Adult; Aged; Anastomosis, Surgical; Anticoagulants; Hematoma; Humans; Intestine, Small; Intussusception; Male; Tomography, X-Ray Computed; Warfarin

Intramural hematoma of the intestine is a rare complication of anticoagulant therapy. We evaluated 7 nontrauma patients with intramural hematoma of the intestine diagnosed at our institution between May 1998 and June 2001. All of the patients were receiving long-term anticoagulant therapy for previous diseases. All 7 patients had abdominal pain, 6 had additional symptoms of nausea and vomiting, and 4 had melanotic stools at admission. Six of the patients had abnormal coagulation parameters. Both abdominal ultrasonography (US) and computerized tomography (CT) showed the exact pathology in all patients. Five of the 7 patients were treated, nonoperatively, and the other patients underwent surgery. All of the patients were followed with abdominal US and CT (mean 12 = months), with complete resolution of their intramural hematomas. Abdominal US and CT evaluation performed together will help the accuracy of diagnosis of intramural hematoma, but nonoperative therapy is the treatment of choice, with surgery indicated if generalized peritonitis or intestinal obstruction develops.

Topics: Abdomen; Abdomen, Acute; Abdominal Pain; Adult; Aged; Anticoagulants; Diagnosis, Differential; Drug Overdose; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Middle Aged; Radiography, Abdominal; Treatment Outcome; Ultrasonography; Warfarin

Chronic anticoagulant treatment is administered mostly for cardiological reasons. Cumarin derivatires are used in the majority of cases (Warfarin, Pelentan). It is necessary to monitor this treatment regularly and to control the dose according to the INR value. Different complications can occur; the haemorrhage represents a serious one. The authors discuss several aspects of anticoagulant therapy and possible prevention of the complications. The importance of the problems is demonstrated on the authors' clinical experience--two cases of haemorrhage after Warfarin administration simulating an acute surgical event.

Topics: Abdomen, Acute; Abdominal Muscles; Aged; Aged, 80 and over; Anticoagulants; Ethyl Biscoumacetate; Female; Hematoma; Hemorrhage; Humans; Male; Retroperitoneal Space; Warfarin

There are few reported cases of acute portal vein thrombosis presenting as an acute abdomen in adolescent age group. Most published series concern chronic extrahepatic portal vein thrombosis. Acute portal vein thrombosis is rare, but can develop into serious complications. Hence, prompt diagnosis and heparinization can prevent the development of lethal complications such as venous gangrene of the bowel and portal hypertension.

Topics: Abdomen, Acute; Adolescent; Heparin; Humans; Male; Portal Vein; Radiography; Recurrence; Thrombosis; Ultrasonography; Warfarin

Topics: Abdomen, Acute; Aorta, Abdominal; Aortic Aneurysm; Humans; Male; Middle Aged; Pain; Phlebography; Pulse; Rupture; Vena Cava, Inferior; Warfarin

Topics: Abdomen, Acute; Hemoperitoneum; Humans; Intestinal Obstruction; Jejunum; Male; Middle Aged; Warfarin

Topics: Abdomen, Acute; Barium Sulfate; Blood Pressure; Blood Transfusion; Cerebrovascular Disorders; Duodenum; Female; Hematemesis; Hematuria; Hemoperitoneum; Humans; Intestinal Obstruction; Jejunum; Laparotomy; Male; Melena; Middle Aged; Myocardial Infarction; Prothrombin Time; Radiography; Vitamin K 1; Warfarin

Topics: Abdomen, Acute; Abdominal Muscles; Diagnosis, Differential; Female; Hematoma; Humans; Middle Aged; Warfarin

Topics: Abdomen; Abdomen, Acute; Diagnosis; Heart Failure; Heparin; Humans; Infarction; Intestine, Small; Intestines; Surgical Procedures, Operative; Warfarin