Spontaneous intramural small-bowel hematoma
Epigastric pain. Coumarin intoxication.
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A long jejunal segment circumferential wall thickening, luminal narrowing and intramural hyperdensity (HU level of 60.91) with dilated bowel proximally and collapsed distally (small bowel obstruction). No free fluid or free air can be seen.
Nontraumatic small-bowel hematoma is a rare complication of oral anticoagulation therapy. Patients present usually with abdominal pain, intestinal obstruction or an acute abdomen.
CT characteristics range from circumferential wall thickening, luminal narrowing, intramural hyperdensity and intestinal obstruction.