warfarin and Jejunal-Diseases

Warfarin is an anticoagulant agent known to have a common complication, bleeding. Intramural intestinal haematoma is an uncommon incidence of warfarin-induced haemorrhage. Abdominal pain is its most frequent symptom and presentation with upper-gastrointestinal haemorrhage is rarely seen. Here, we present a 67-year-old male who was admitted to the hospital with active upper-gastrointestinal haemorrhage. In this case, the cause of bleeding has been attributed to duodenal intramural haematoma due to warfarin overuse.

Topics: Aged; Anticoagulants; Duodenal Diseases; Hematemesis; Hematoma; Humans; Jejunal Diseases; Male; Warfarin

Oral anticoagulant therapy with warfarin is commonly used to prevent thromboembolic event in patients at risk with atrial fibrillation [1]. Spontaneous intramural hematoma of small intestine is rare complication of anticoagulant therapy and occurs in patient who receives excessive warfarin that may result in potentially serious complications. Small bowel intramural hematoma secondary to warfarin therapy is a recognized complication [2]. In the present report, we report an unusual case of small bowel intramural hemorrhage secondary to anticoagulant therapy after abdominal massage. The emergency physicians should be aware that the potential spontaneous small bowel intramural hemorrhage in the patients has a high index of suspicion because most patients are treated nonoperatively with a good outcome.

Topics: Aged; Anticoagulants; Hematoma; Humans; Intestinal Obstruction; Jejunal Diseases; Male; Massage; Tomography, X-Ray Computed; Warfarin

Topics: Aged, 80 and over; Anticoagulants; Female; Hematoma; Humans; International Normalized Ratio; Jejunal Diseases; Tomography, X-Ray Computed; Warfarin

The study aimed to predict effective human jejunal permeability (P(eff)) using a biophysical model based on parametrized paracellular, aqueous boundary layer, and transcellular permeabilities, and the villus-fold surface area expansion factor (k(VF)). Published human jejunal data (119 P(eff), 53 compounds) were analyzed by a regression procedure incorporating a dual-pore size paracellular model. Transcellular permeability, scaled by k(VF), was equated to that of Caco-2 at pH 6.5. The biophysical model predicted human jejunal permeability data within the experimental uncertainty. This investigation revealed several surprising predictions: (i) many molecules permeate predominantly (but not exclusively) by the paracellular route, (ii) the aqueous boundary layer thickness in the intestinal perfusion experiments is larger than expected, (iii) the mucosal surface area in awake humans is apparently nearly entirely accessible to drug absorption, and (iv) the relative "leakiness" of the human jejunum is not so different from that observed in a number of published Caco-2 studies.

Topics: Animals; Disease Models, Animal; Dogs; Humans; Jejunal Diseases; Kidney Diseases; Models, Biological; Permeability; Porosity; Regression Analysis

Topics: Anticoagulants; Hematoma; Humans; Jejunal Diseases; Male; Middle Aged; Warfarin

Intramural hematoma of the small bowel is an infrequent complication of the use of oral anticoagulants. Diagnosis can only be performed when these symptoms are associated with a history of oral anticoagulant use and radiological tests. We report the case of a patient admitted for epigastric pain associated with oral anticoagulation therapy with warfarin and a 48-h history of retention vomiting. Ultrasound and abdominal computed tomography scans revealed a jejunal loop with diffuse parietal thickening, suggesting an intramural hematoma. Conservative therapy was provided with symptomatic regression on the second day and reabsorption of the jejunal intramural hematoma. Anticoagulation therapy was reintroduced with no recurrences.

Topics: Aged; Anticoagulants; Hematoma; Humans; Jejunal Diseases; Male; Warfarin

Topics: Aged; Anticoagulants; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Volvulus; Jejunal Diseases; Tomography, X-Ray Computed; Warfarin

In the case presented here, we have succeeded in describing the endoscopic findings of anticoagulant ileus and evaluated the degree of bleeding as well as ischemia through endoscopic observation. We have demonstrated that enteroscopy using the double-balloon method is a useful diagnostic tool in the evaluation of a patient suspected to have anticoagulant ileus.

Topics: Anticoagulants; Catheterization; Endoscopy, Gastrointestinal; Hematoma; Humans; Ileus; Jejunal Diseases; Male; Middle Aged; Warfarin

Topics: Abdominal Pain; Anticoagulants; Hematoma; Humans; Jejunal Diseases; Male; Middle Aged; Warfarin

Topics: Anticoagulants; Gastrointestinal Hemorrhage; Hematoma; Humans; Intestinal Obstruction; Jejunal Diseases; Male; Middle Aged; Warfarin