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Related Experiment Videos

Warfarin-induced gastric bleeding and intestinal obstruction.

Nimrod Maimon1, Todd Penner, Wilfred Demajo

  • 1Division of Respirology, Department of Medicine, Western Hospital, University Health Network, University of Toronto, 1 King's College Circle, Rm 6263 MSB, Toronto, ON, Canada M5S 1A8.

European Journal of Internal Medicine
|April 19, 2006
PubMed
Summary

Warfarin therapy can rarely cause internal bleeding, leading to a life-threatening bowel obstruction. This case highlights an unusual complication of anticoagulant treatment requiring surgical intervention.

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Surgical Oncology

Background:

  • Oral anticoagulants like warfarin are crucial for preventing thromboembolic events.
  • Warfarin therapy requires frequent monitoring due to variable patient responses and bleeding risks.
  • Excessive anticoagulation is directly linked to an increased risk of bleeding complications.

Purpose of the Study:

  • To report a rare case of warfarin-induced intraluminal hematoma causing mechanical ileus.
  • To highlight a potentially lethal, previously undescribed manifestation of warfarin therapy.

Main Methods:

  • A patient presented with acute abdomen, anemia, and elevated international normalized ratio (INR).
  • Diagnostic procedures included gastroscopy and laparotomy.

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  • Surgical intervention involved evacuating an intraluminal hematoma.
  • Main Results:

    • Gastroscopy revealed significant gastric hemorrhage.
    • Laparotomy identified ischemic small bowel secondary to increased intraluminal pressure from a hematoma.
    • Evacuation of the hematoma restored intestinal blood supply.

    Conclusions:

    • Intraluminal hematoma is a rare cause of obstructive mechanical ileus in patients on warfarin.
    • This case expands the spectrum of known warfarin-related complications.
    • Early recognition and surgical management are critical for this potentially fatal condition.