[Intraabdominal and intramural hemorrhage due to warfarin therapy].

BACKGROUND

The study investigated clinical, radiological findings and treatment methods used in patients who developed intraabdominal hemorrhage due to chronic warfarin use.

METHODS

Eight patients receiving warfarin for cardiac valve replacement, pulmonary thromboemboli, and atrial fibrillation were admitted to our hospital. The patients had abdominal pain, nausea, and vomiting although there was no hematemesis and melena.

RESULTS

Abdominal ultrasonography and computerized tomography identified the individuals' problems as intraabdominal hemorrhage (n=2), intestinal intramural and intraabdominal hemorrhage (n=2), bleeding into the sheath of the rectus abdominus muscle (n=1), subcapsular splenic hemorrhage (n=1), and bleeding due to ruptured ovarian cyst (n=2).

CONCLUSIONS

Clinicians must be alert for intraabdominal bleeding in patients who are prescribed warfarin treatment. Abdominal ultrasonography and computerized tomography should be used to investigate all such cases of suspected hemorrhage. Blood and plasma replacements are first line of supportive treatment and surgery should be avoided if possible.