Hou SW, Chen CC, Chen KC, Ko SY, Wong CS, Chong CF
Sonographic diagnosis of spontaneous intramural small bowel hematoma in a case of warfarin overdose. [JOURNAL ARTICLE]
J Clin Ultrasound 2008 Jan 14.
A 38-year-old man who had been treated with warfarin since mitral valve replacement 10 years earlier presented with acute onset of epigastralgia and melena. Coagulation tests were abnormal with a prolonged prothrombin time of >60 seconds and a prolonged activated partial thromboplastin time of >120 seconds. Abdominal sonographic examination revealed duodenal intramural hematoma that was confirmed on CT. Warfarin therapy was stopped and the patient was treated conservatively with vitamin K and fresh frozen plasma. Recovery was uneventful, and the patient was re-warfarinized 2 weeks later. Duodenal hematoma can be readily diagnosed with bedside sonography. (c) 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.
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