Spontaneous intramural small bowel hemorrhage

Discussion:

The patient underwent surgery. Surgery confirms submucosal jejunal hematoma on left with hemoperitoneum.

The patient has a history of coronary artery bypass grafting (CABG) surgery and was taking anticoagulation medication. The absence of vascular occlusion and filling defect on CT imaging makes differentiation of ischemia from intramural hematoma or inflammation difficult.

A combination of history, physical examination, and imaging findings are all important in establishing the correct diagnosis.

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