Intestinal intramural hematoma: A rare complication of Anticoagulation Therapy

Main Article Content

Kağan Gökçe
Demet Doğan
Merve Yazıcı


Objective: Anticoagulant therapy is commonly used in the treatment of cardiac and thromboembolic diseases, with bleeding being the most common side effect, which increases in likelihood with prolonged usage. Intestinal intramural hematoma, although rare, is a potential complication of anticoagulant therapy.

Case: Herein, we present the case of a 49-year-old male patient who presented to our outpatient general surgery clinic with complaints of nausea, vomiting, and abdominal pain. Upon examination, electrocardiography (ECG) revealed sinus rhythm without any ischemic changes, and echocardiography findings were within normal limits. The patient reported the use of warfarin, and his International Normalized Ratio (INR) was found to be 14.7 (normal range: 0.8-1.1). A 10 mg (1 ampoule) intravenous (IV) infusion of vitamin K was administered, and the warfarin dosage was adjusted accordingly. Subsequent follow-up assessments showed normalization of the INR levels.

Conclusion: Intestinal intramural hematoma is an exceedingly rare condition that necessitates prompt diagnosis and intervention, as delayed recognition can lead to life-threatening complications. Clinicians should maintain a high index of suspicion for intestinal obstruction secondary to anticoagulant therapy in patients presenting to the emergency department with symptoms such as abdominal pain, nausea, and vomiting.


Download data is not yet available.

Article Details

How to Cite
Gökçe, K., Doğan, D., & Yazıcı, M. (2024). Intestinal intramural hematoma: A rare complication of Anticoagulation Therapy. Medical Science and Discovery, 11(4), 143–146.
Case Reports
Received 2024-02-05
Accepted 2024-02-24
Published 2024-04-30


Wang J, Sun X, Shi H, Cao D. Intramural hematoma of colon: Case report of 2 cases. Medicine (Baltimore). 2020; 99(10):e19404.

El Aidaoui K, Lahlou W, Bourial A, et al. Intestinal Spontaneous Intramural Hematoma Secondary to Anticoagulation Therapy: A Case Report. Cureus. 2023; 15(4):e37257.

Vecchio R, Cacciola E, Figuera M, et al. Idiopathic intramural hematoma of the right colon. A case report and review of the literature. Int J Surg Case Rep. 2019; 60:16-20.

Yoldaş T, Erol V, Çalışkan C, et al. Spontaneous intestinal intramural hematoma: What to do and not to do. Ulus Cerrahi Derg. 2013; 29(2):72-5.

Samir R, Hashem MB, Badary HA, et al. Perspectives and Management Strategies for Acute Colonic Intramural Hematoma. Int J Gen Med. 2022; 15:2861-2865.

Acar N, Acar T, Gungor F, et al. A Rare Complication of Anticoagulant Therapy: Intramural Hematoma of the Small Bowel. Arch Iran Med. 2019; 22(11):653-658.

Khan K, Saeed S, Alothman S, et al. Warfarin induced mesenteric and intestinal hematoma requiring surgical resection to relieve small bowel obstruction: A case report. Int J Surg Case Rep. 2018; 52:111-113.

Patil AS, Shriya S, Dhimole N, More J. Intramural Jejunal Hematoma Causing Intermittent Bowel Obstruction-A Rare Manifestation of Warfarin Toxicity. Surg J (N Y). 2022; 8(4):e290-e292.

Zhu Y, Wang C, Xu C, Liu J. Case Report: Spontaneous Intramural Hematoma of the Colon Secondary to Low Molecular Weight Heparin Therapy. Front Pharmacol. 2021; 12:598661.

Uzun MA, Koksal N, Gunerhan Y, et al. Intestinal obstruction due to spontaneous intramural hematoma of the small intestine during warfarin use: a report of two cases. Eur J Emerg Med. 2007; 14(5):272-3.

Polat C, Dervisoglu A, Guven H, et al. Anticoagulant-induced intramural intestinal hematoma. Am J Emerg Med. 2003 ;21(3):208-11.