[Intramural hematoma of the duodenum as complication in anticoagulant therapy. Diagnosis and therapy]

We report the history of a 68-year-old man who has been hospitalized for an aortic valve endocarditis. The patient was under full anticoagulation therapy because of an artificial aortic valve (Omnicarbon 23 mm). During hospitalization the patient developed a subacute abdomen accompanied by upper gastrointestinal tract hemorrhage. At endoscopy and radiology an intramural hematoma of the duodenum was found. The typical findings of intramural hematoma such as abdominal X-ray, ultrasound, CT scan, selective small bowel transit and endoscopy are presented and the history as well as therapeutic modalities discussed.