Warfarin Therapy and Intestinal Obstruction — An Unusual Case Report

The occurrence of bleeding complications associated with anticoagulation therapy varies between 5 and 48%, with gastrointestinal bleeding being reported in only 2 to 4% of cases (1). Spontaneous intramural haematoma, though rare, is often caused by warfarin over-anticoagulation (1, 2). Other risk factors include haemophilia, idiopathic thrombocytopenic purpura, leukaemia, lymphoma, myeloma, chemotherapy, vasculitis, pancreatitis, and pancreatic cancer (2). Symptoms range from mild abdominal pain and vomiting to acute abdomen with intestinal obstruction (3). Diagnosis typically involves ultrasound and contrast-enhanced computed tomography (CECT). Treatment is usually conservative, but surgery may be necessary for intestinal obstruction, ischaemia, perforation, peritonitis, and intra-abdominal hemorrhage (1), We discuss a case of spontaneous intramural jejunal haematoma causing small bowel obstruction, successfully managed conservatively.