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Sonographic diagnosis of spontaneous intramural small bowel hematoma in a case of warfarin overdose
Author(s) -
Hou ShengWen,
Chen ChienChih,
Chen KuoChih,
Ko ShihYu,
Wong ChungShun,
Chong CheeFah
Publication year - 2008
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20442
Subject(s) - medicine , warfarin , melena , hematoma , fresh frozen plasma , partial thromboplastin time , surgery , prothrombin time , ultrasound , coagulation testing , radiology , anesthesia , coagulation , atrial fibrillation , platelet
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. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.