Haematoma intramural

Marco M, Guy AJ Retr ritcmeal haematona and all bowel intramural haematoma caused by warfarin and micCTiazole interaction. IntJ OralMaxillofac Surg (1997) 27,485. 

Crohn s disease (Ulcerative) colitis Intestinal ischaemia Intestinal tuberculosis Intestinal invagination Diverticulitis Post-radiation enteritis Adenocarcinoma Gastrointestinal stromal tumour Intestinal metastases Appendicitis Intramural haematoma... 

Mastrobuoni S, Robblee JA, Boodhwani M. Spontaneous ascending aortic intramural haematoma in a patient on dabigatran. Interact Cardio-vasc Thorac Surg2012 15(2) 299 00. 

Perforation of Peptic Ulcer 217 Acute Gastric Volvulus 218 Proximal Small Bowel Volvulus Emphysematous Gastritis 222 Injuries to the Stomach and Duodenum 224 Rupture of the Stomach 224 Intramural Haematoma of the Duodenum 224 Retroperitoneal Rupture of the Duodenum 226 Diaphragmatic Rupture 226 References 228... 

Fig. 12.14a,b. Duodenal haematomas. a A barium study showing an intramural haematoma in an anticoagulated patient b CECT demonstrating massive intraluminal clot arising from a bleeding duodenal ulcer also in an anticoagulated patient... 

Gastrointestinal An 80-year-old woman presented as an emergency case after 2 weeks of vomiting, abdominal pain and diarrhoea. She had commenced warfarin use 3 weeks prior for paroxysmal atrial fibrillation. An X-ray revealed concentric mural thickening of the proximal jejunum, extending distally from the duodenal-jejxmal flexure and the provisional diagnosis was a spontaneous intramural jejunal haematoma. Warfarin was withheld and with Vitamin K, 3-factor prothrombin complex concentrate and fresh frozen plasma treatment, she recovered and tire abnormality resolved [3 ]. 

Frank rectal bleeding or melaena is common and is associated with the presence of intramural haemorrhages. Constant diffuse abdominal pain is common, and pain in the back raises the possibility of retroperitoneal haematoma. Colicky abdominal pain is also frequent and may last for several months following the initial injury. It is an indication for repeated re-examination. 

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