warfarin and Intestinal-Diseases

Topics: Aged; Anticoagulants; Hematoma; Humans; Intestinal Diseases; Intestine, Small; Male; Tomography, X-Ray Computed; Warfarin

Spontaneous intramural hematoma of the small intestine is a rare clinical condition that may result in potentially serious complications. The purpose of this study was to present our experience with the diagnosis and management of spontaneous intramural hematoma of the small intestine.. The medical records of the patients with spontaneous intramural hematoma of the small intestine were retrospectively reviewed. Six patients were included in this study.. Anticoagulation therapy and factor VIII deficiency were found to be responsible for the intramural hemorrhage in five patients (83%) and one patient, respectively. Acute abdominal pain followed by nausea and vomiting were the most common presenting symptoms. Abdominal computed tomography scan was diagnostic in five of the six patients. Four patients were followed up with conservative therapy. Surgical intervention was required in two patients due to acute abdomen. All patients were discharged from the hospital uneventfully.. The patient's medical history, physical examination and radiological evaluation proved adequate for the diagnosis. Conservative therapy provides regression of the hematoma in most patients. Surgery should be reserved only for the complicated cases.

Topics: Adult; Aged; Anticoagulants; Aspirin; Hematoma; Hemophilia A; Humans; Intestinal Diseases; Intestine, Small; Male; Middle Aged; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome; Warfarin

Topics: Aged; Hematoma; Humans; Intestinal Diseases; Intestine, Small; Male; Radiography, Abdominal; Tomography; Warfarin

Topics: Adult; Aged; Anticoagulants; Breath Tests; Dose-Response Relationship, Drug; Female; Humans; Intestinal Diseases; Intestine, Small; Lactulose; Male; Middle Aged; Venous Thromboembolism; Vitamin K; Warfarin

Capsule endoscopy is a promising method for examining the small intestine. The study was performed to evaluate the use of capsule endoscopy in clinical routine in patients with suspected disease of the small intestine.. Consecutive patients with clinically suspected disease of the small intestine referred for capsule endoscopy between 1 January 2003 and 31 December 2004 were included in the study. All patients had previously completed a conventional diagnostic work-up with upper and lower endoscopy as well as abdominal CT scan or small-bowel enteroclysis.. A total of 167 patients were referred during the time period and 195 procedures were performed. Seventeen (8.7%) of the procedures were unsuccessful, with no visualization of the small bowel. In the remaining procedures the caecum was reached in 83%. The reason for referral was gastrointestinal bleeding (30%), iron-deficiency anaemia (25%), abdominal pain (15%), diarrhoea (13%) and Crohn's disease (12%). Pathology was found in 27% of the patients, with the highest diagnostic yield in patients referred for Crohn's disease (60%) and the lowest yield (4%) in patients referred for abdominal pain. There were no complications, with the exception of one patient referred for Crohn's disease who had transient abdominal pain during the procedure.. Capsule endoscopy is a safe and well-tolerated procedure. In unselected patients with clinically suspected disease of the small intestine, the procedure gives additional information to conventional diagnostic procedures in 27% of patients. Incomplete examination of the small intestine was frequent in our group of patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Cyclooxygenase Inhibitors; Diarrhea; Endoscopy, Gastrointestinal; Female; Humans; Intestinal Diseases; Intestine, Small; Male; Middle Aged; Norway; Prospective Studies; Warfarin

Coumadin is a coumarin anticoagulant that induces a state similar to vitamin K deficiency and is routinely used for chronic oral anticoagulation. Intramural hematoma of the bowel is a rare complication of anticoagulant therapy. In this paper, we describe such a case of an anticoagulated patient who had complaints of abdominal pain and who had inadvertently been taking higher dose of coumadin. Although the diagnosis can usually be made by history and plain abdominal x-ray, we report here some radiographic signs that can be seen on a CT-scan of the abdomen and are relatively specific for this diagnosis. We stress the importance of recognizing the disorder because the management is conservative and surgery is reserved for cases in which no improvement is seen.

Topics: Drug Overdose; Female; Hematoma; Humans; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Middle Aged; Warfarin

The case of a 41-year-old male with a history of multiple emboli and short bowel syndrome who was successfully anticoagulated with sodium warfarin is described. The prothrombin times were stabilized in a therapeutic range with warfarin doses of 5.0 mg -7.5 mg daily. The pharmacokinetics of warfarin suggests that absorption is high in the proximal intestine. The successful use of sodium warfarin in the patient substantiates this finding and demonstrates that short bowel does not necessarily preclude the use of warfarin for anticoagulation. It is suggested that patients with short bowel syndrome may be successfully anticoagulated with oral products; however, careful monitoring of each patient's prothrombin time is necessary because of the variability and extent of bowel loss.

Topics: Adult; Embolism; Humans; Intestinal Diseases; Intestines; Male; Postoperative Complications; Time Factors; Warfarin

Topics: Abdominal Muscles; Aged; Cysts; Diagnosis, Differential; Female; Hematoma; Hemorrhage; Heparin; Hernia; Humans; Intestinal Diseases; Male; Middle Aged; Neoplasms; Radiography; Rest; Warfarin

Topics: Diagnosis; Dicumarol; Geriatrics; Hematoma; Humans; Intestinal Diseases; Intestine, Small; Intestines; Radiography; Toxicology; Warfarin

Topics: Anticoagulants; Geriatrics; Hematoma; Humans; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Myocardial Infarction; Surgical Procedures, Operative; Toxicology; Warfarin