[Intestinal infarct due to spontaneous mesenterial and intramural anticoagulant hemorrhage]

A 69-year-old man who had been anticoagulated for 18 months reported with acute pain in the epigastric region. Laparotomy revealed more than 1 liter of unclotted blood in the peritoneal cavity and, in the mesentery of the medium small bowel, a number of fist-size hematomas and a 30 cm long, hemorrhagic, fibrin-coated small bowel segment gangrenously infarcted in the middle section. It is shown why a spontaneous "anticoagulant" hemorrhage must be regarded as the cuase of the gangrenous intestinal infarction.