Spontaneous intramural hematoma of the small intestine

BACKGROUND
Spontaneous intramural hematoma of the small intestine is a rare clinical condition that may result in potentially serious complications. The purpose of this study was to present our experience with the diagnosis and management of spontaneous intramural hematoma of the small intestine.
METHODS
The medical records of the patients with spontaneous intramural hematoma of the small intestine were retrospectively reviewed. Six patients were included in this study.
RESULTS
Anticoagulation therapy and factor VIII deficiency were found to be responsible for the intramural hemorrhage in five patients (83%) and one patient, respectively. Acute abdominal pain followed by nausea and vomiting were the most common presenting symptoms. Abdominal computed tomography scan was diagnostic in five of the six patients. Four patients were followed up with conservative therapy. Surgical intervention was required in two patients due to acute abdomen. All patients were discharged from the hospital uneventfully.
CONCLUSION
The patient’s medical history, physical examination and radiological evaluation proved adequate for the diagnosis. Conservative therapy provides regression of the hematoma in most patients. Surgery should be reserved only for the complicated cases.

Spontan intramural ince baðýrsak hematomu

AMAÇ
Spontan ince baðýrsak hematomu nadir görülen ve ciddi komplikasyonlara neden olabilen bir klinik durumdur. Bu çalýþmanýn amacý, spontan intramural ince baðýrsak hematomu saptanan olgularda taný, tedavi ve takipteki tecrübelerimizi sunmaktýr.
GEREÇ VE YÖNTEM
Ýnce baðýrsak spontan intramural hematom tanýsý konulan hastalarýn verileri retrospektif olarak incelendi. Altý hasta çalýþmaya dahil edildi.
BULGULAR
Ýntramural kanamaya neden olarak dört hastada (%83) antikoagülasyon tedavisi ve bir hastada faktör VIII eksikliði belirlendi. Akut karýn aðrýsý, bulantý ve kusma en sýk baþvuru þikayetleri idi. Altý hastanýn beþinde taný karýn bilgisayarlý tomografisi ile kondu. Dört hasta konservatif olarak takip edildi ve iki hastada akut karýna baðlý cerrahi giriþime gerek duyuldu. Tüm hastalar sorunsuz taburcu edildi.
SONUÇ
Fiziksel inceleme ve radyolojik tetkikler hastalarýn özgeçmiþleri ile beraber deðerlendirildiðinde taný için yeterlidir. Konservatif tedavi hastalarýn çoðunda hematomun gerilemesini saðlar. Cerrahi tedavi komplike olgularda uygulanmalýdýr.