| Anticoagulant-induced intramural intestinal hemorrhage. | |
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MedLine Citation:
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PMID: 20887911 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Long-term use of warfarin can provide benefits in the treatment of many diseases, but adverse bleeding events are unpreventable because of a narrow therapeutic range. OBJECTIVE: The aim of this retrospective chart review with data abstraction was to investigate the clinical presentations of intestinal intramural hemorrhage in emergency department (ED) patients. METHODS: We reviewed the cases of 17 patients with acute abdominal pain in our ED. Medical records including demographic data and results of abdominal computed tomography were retrospectively reviewed and analyzed. RESULTS: The mean ± SD age of the reviewed patients was 77.7 ± 8.5 years (range, 60-93 years). The mean ± SD duration from onset of symptoms to ED visit was 2.5 ± 1.3 days (range, 1-5 days). All patients had abdominal pain, and 64.7% had nausea/vomiting. A total of 64.7% of patients had peritoneal signs. The jejunum was most commonly involved (88.2% of all cases). The maximal mean ± SD wall thickening of the bowel was 14.1 ± 4.4 mm (range, 7.4-26.7 mm), and the estimated mean ± SD length was 35.6 ± 24.4 cm (range, 9-105 cm). The mean ± SD prothrombin time and activated partial thromboplastin time were prolonged to 86.5 ± 26.9 and 116.2 ± 43.1 seconds, respectively. All patients received medical treatment and survived. At the last follow-up (mean, 27.4 months), none of the patients had recurrence of intestinal intramural hemorrhage or intestinal obstruction. CONCLUSION: Prolonged prothrombin time and drug history can indicate the possibility of intramural intestinal hemorrhage, and abdominal computed tomography may help to exclude surgical diseases and prevent unnecessary surgery. |
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Authors:
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Chia-Ying Tseng; Ju-Sing Fan; Shu-Chuan Yang; Hsien-Hao Huang; Jen-Dar Chen; David Hung-Tsang Yen; Chun-I Huang |
Publication Detail:
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Type: Journal Article Date: 2010-03-09 |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 28 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: 2010-10-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 937-40 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Emergency Department, China Medical University Hospital, Taiwan 40447. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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etiology Aged Aged, 80 and over Anticoagulants / adverse effects* Emergency Service, Hospital / statistics & numerical data Female Gastrointestinal Hemorrhage / chemically induced*, diagnosis, etiology Humans Male Middle Aged Partial Thromboplastin Time Prothrombin Time Retrospective Studies Statistics, Nonparametric Time Factors Tomography, X-Ray Computed Treatment Outcome Warfarin / adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 81-81-2/Warfarin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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