Anticoagulant-induced hematomas of the small intestine

Intramural hematomas of the small bowel, an uncommon complication of anticoagulant therapy, usually present with nausea, vomiting, crampy abdominal pain, and often gastrointestinal bleeding of some degree. The diagnosis can be suggested by history and by a plain abdominal x-ray film, but an upper GI series is the most reliable means of confirming the diagnosis. Treatment is nonoperative, with emphasis on correction of clotting abnormalities, and blood loss, continuous nasogastric decompression, parenteral alimentation, and hydration.