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Superwarfarin poisoning as a cause of intestinal obstruction

Hu Nie1, Wei Wei, Yu Cao

  • 1Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China. dr.hu.nie@gmail.com

Clinical Toxicology (Philadelphia, Pa.)
|February 10, 2010
PubMed

Insights

Superwarfarin poisoning caused acute intestinal obstruction in a teen. Prompt treatment with vitamin K1 and fresh frozen plasma successfully resolved the condition, avoiding surgery.

Area of Science:

  • Toxicology
  • Gastroenterology
  • Internal Medicine

Background:

  • Acute intestinal obstruction is a critical surgical emergency.
  • Superwarfarin poisoning is a rare but serious condition with potential for severe complications.
  • Early diagnosis and management are crucial for favorable outcomes.

Observation:

  • A 17-year-old male presented with symptoms of bowel obstruction including nausea, vomiting, abdominal distension, and pain.
  • Abdominal CT revealed extensive gas-fluid levels and intestinal wall swelling, indicative of acute intestinal obstruction.
  • Coagulation tests showed abnormalities, suggesting superwarfarin poisoning.

Findings:

  • Superwarfarin poisoning was confirmed as the underlying cause of the acute intestinal obstruction.
  • High-dose vitamin K1 and fresh frozen plasma therapy were administered.
  • The patient's condition improved significantly, leading to the avoidance of surgical intervention.

Implications:

  • This case highlights the importance of considering superwarfarin poisoning in patients with unexplained intestinal obstruction and coagulopathy.
  • Aggressive vitamin K1 therapy can be effective in managing superwarfarin-induced coagulopathy and related complications.
  • Non-surgical management is feasible for superwarfarin-induced intestinal obstruction with timely and appropriate treatment.

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