Juliano Faria, Roberta Pessoa, Marcelo Hudson, Sílvio Vitoi, Ovídio Villela, José Torres, Mara Delgado Paula, Aloísio Bemvindo
Radiol Bras 2004;37(6):461-463 - CASE REPORT
We report a case of a patient receiving chronic oral anticoagulant therapy with Warfarin who presented with acute intestinal obstruction. Computed tomography showed intramural duodenal hematoma. Treatment was conservative with correction of the coagulation parameters and observation. This case exemplifies the usefulness of conservative therapy and computed tomography in patients with acute small bowel obstruction receiving anticoagulant therapy.
Intramural duodenal hematomas secondary to blunt trauma, determining rapid luminal obstruction, are rare, benign lesions and may be confused with obstructive neoplastic conditions (either parietal or produced by extrinsic compression mechanisms). The present report describes a case of post-traumatic intestinal obstruction by an intramural hematoma in the third duodenal segment. Imaging diagnosis and the conservative management of such obstruction are discussed.
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