Syndrome occlusif et hémorragique révélant un hématome duodénal intramural iatrogène

Nontraumatic intramural hematoma of the duodenum

We present a case of nontraumatic intramural hematoma of the duodenum. A 77-year-old woman complained of nausea, vomiting, and abdominal pain during hospitalization. There was no traumatic episode. Laboratory data showed anemia (hemoglobin, 7.7 g/dl). The diagnosis was confirmed by computed tomography (CT), which showed a mixed hyperdense and hypodense mass obstructing the third portion of the duodenum. The cause was considered to be bleeding tendency caused by an antiplatelet drug. The patient was treated conservatively and the size of the hematoma was followed on CT. She was able to resume oral feeding 2 weeks after admission.

[Non-traumatic spontaneous intramural hematoma of the small bowel: an infrequent complication of anticoagulation therapy]

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.