[et_pb_section fb_built=\u00bb1″ custom_padding_last_edited=\u00bbon|desktop\u00bb admin_label=\u00bbHeader\u00bb _builder_version=\u00bb4.16″ background_enable_image=\u00bboff\u00bb background_size=\u00bbcontain\u00bb background_position=\u00bbtop_right\u00bb custom_padding=\u00bb11px||31px||false|false\u00bb custom_padding_tablet=\u00bb2px|0px|50px|0px|false|false\u00bb custom_padding_phone=\u00bb3px|0px|50px|0px|false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.16″ max_width=\u00bb1280px\u00bb custom_margin=\u00bb-11px|auto||auto||\u00bb custom_padding=\u00bb8px||2px|||\u00bb use_custom_width=\u00bbon\u00bb custom_width_px=\u00bb1280px\u00bb collapsed=\u00bbon\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.16″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb][et_pb_text _builder_version=\u00bb4.20.1″ _module_preset=\u00bbdefault\u00bb text_font=\u00bb|700|||||||\u00bb text_font_size=\u00bb16px\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n
Acceso abierto<\/p>\n
[\/et_pb_text][et_pb_text _builder_version=\u00bb4.16.0″ _dynamic_attributes=\u00bbcontent\u00bb text_font=\u00bbEB Garamond||||||||\u00bb text_text_color=\u00bb#000000″ text_font_size=\u00bb50px\u00bb text_line_height=\u00bb1.3em\u00bb header_font=\u00bbEB Garamond||||||||\u00bb header_font_size=\u00bb54px\u00bb header_line_height=\u00bb1.3em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_font_size=\u00bb16px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb max_width=\u00bb900px\u00bb text_font_size_tablet=\u00bb\u00bb text_font_size_phone=\u00bb15px\u00bb text_font_size_last_edited=\u00bbon|tablet\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb header_font_size_tablet=\u00bb50px\u00bb header_font_size_phone=\u00bb32px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF90aXRsZSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IiIsImFmdGVyIjoiIn19@[\/et_pb_text][et_pb_blurb title=\u00bbMar\u00eda S. Fern\u00e1ndez (1), Juan J. Boretti (2), David Biagiola (2), Sebastian Giacosa (3) \u00bb use_icon=\u00bbon\u00bb font_icon=\u00bb||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb custom_margin=\u00bb||8px|||\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n
(1) M\u00e9dica Residente del Servicio de Cirug\u00eda General
(2) M\u00e9dico Especialista en Cirug\u00eda General
(3) M\u00e9dico Especialista en Diagn\u00f3stico por im\u00e1genes
Sanatorio Parque \u2013 Bv. Oro\u00f1o 860, (2000) Rosario, Argentina<\/p>\n
Correspondencia a<\/strong>: fernandezsol95@gmail.com<\/a> [\/et_pb_blurb][et_pb_text _builder_version=\u00bb4.20.4″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb13px\u00bb text_line_height=\u00bb1.6em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Citaci\u00f3n sugerida:<\/strong>\u00a0Fern\u00e1ndez MS, Boretti JJ, Biagiola D y col. Hematoma mural espont\u00e1neo de intestino delgado. Anuario (Fund. Dr. J. R. Villavicencio) 2023;30. Disponible en:\u00a0https:\/\/villavicencio.org.ar\/anuario\/30-hematoma-mural-espontaneo<\/a>. ARK: http:\/\/id.caicyt.gov.ar\/ark:\/\/smpir5qa1<\/a><\/p>\n Este es un art\u00edculo de acceso abierto distribuido bajo los t\u00e9rminos de Creative Commons Attribution License (https:\/\/creativecommons.org\/licen- ses\/by-nc-sa\/4.0\/deed.es), esto permite que Ud. lo use, lo distribuya y lo adapte, sin prop\u00f3sitos comerciales, siempre que se cite correctamente el trabajo original. Si crea un nuevo material con \u00e9l, debe distribuirlo con la misma licencia.<\/p>\n [\/et_pb_text][et_pb_button button_url=\u00bb\/anuario\/30\/hematoma-mural-espontaneo.pdf\u00bb url_new_window=\u00bbon\u00bb button_text=\u00bbDescargar art\u00edculo\u00bb button_alignment=\u00bbright\u00bb _builder_version=\u00bb4.20.2″ custom_button=\u00bbon\u00bb button_text_size=\u00bb12px\u00bb button_text_color=\u00bb#3cbebe\u00bb button_bg_color=\u00bbrgba(60,190,190,0.1)\u00bb button_border_width=\u00bb10px\u00bb button_border_color=\u00bbrgba(0,0,0,0)\u00bb button_border_radius=\u00bb100px\u00bb button_letter_spacing=\u00bb1px\u00bb button_font=\u00bb|700||on|||||\u00bb custom_padding=\u00bb10px|20px|10px|20px|true|true\u00bb button_letter_spacing_hover=\u00bb1px\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb button_text_size__hover_enabled=\u00bboff\u00bb button_one_text_size__hover_enabled=\u00bboff\u00bb button_two_text_size__hover_enabled=\u00bboff\u00bb 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button_two_bg_color__hover_enabled=\u00bboff\u00bb][\/et_pb_button][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbCourses\u00bb _builder_version=\u00bb4.16″ custom_padding=\u00bb1px|0px|62px|0px|false|false\u00bb collapsed=\u00bbon\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row custom_padding_last_edited=\u00bbon|phone\u00bb _builder_version=\u00bb4.16″ background_color=\u00bb#ffffff\u00bb max_width=\u00bb1280px\u00bb custom_padding=\u00bb12px|40px|12px|40px|true|false\u00bb custom_padding_tablet=\u00bb\u00bb custom_padding_phone=\u00bb|20px||20px||true\u00bb animation_style=\u00bbzoom\u00bb animation_intensity_zoom=\u00bb2%\u00bb border_radii=\u00bbon|12px|12px|12px|12px\u00bb box_shadow_style=\u00bbpreset1″ box_shadow_vertical=\u00bb50px\u00bb box_shadow_blur=\u00bb80px\u00bb box_shadow_color=\u00bbrgba(15,19,25,0.1)\u00bb use_custom_width=\u00bbon\u00bb custom_width_px=\u00bb1280px\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.16″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Hematoma espont\u00e1neo, intestino delgado.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Introduction: Spontaneous mural hematoma of the small bowel is a rare entity which should be suspected in patients with a history of blood dyscrasias or under anticoagulant therapy, it presents accompanied by abdominal pain. Contrast-enhanced abdominal computed tomography is of great diagnostic value.<\/p>\n Objective: A clinical case of spontaneous mural hematoma of the small intestine was presented; diagnostic methods and subsequent therapeutic resolution were indicated.<\/p>\n Case presentation:\u00a0 A 71-year-old female patient with a history of deep vein thrombosis under chronic treatment with oral anticoagulants for more than 30 years is presented. Clarithromycin 250 mg every 12 hours orally was prescribed due to upper airway infection. Five days after the beginning of the intake, the patient developed continuous abdominal pain.<\/p>\n The blood test showed stable hematocrit and alteration in the coagulation times.<\/p>\n A computed axial tomography was performed without signs of intestinal occlusion; therefore a medical control was decided. During the evolution, the patient developed worsening of abdominal symptoms; a video laparoscopy was performed and free blood was found in the abdominal cavity (hemoperitoneum).\u00a0 Almost 25 cm of the proximal small bowel was involved, which was enlarged and the corresponding meso showed a contained hematoma.<\/p>\n The segment of small bowel involved was resected with anastomosis. The patient evolved favorably and was discharged on the fourth day after surgery.<\/p>\n Conclusions: The most common responsible drug turned out to be warfarin (81%) and the most frequent site where spontaneous hematomas occur was the ileum (46%). Surgery is indicated In cases of intestinal occlusion, signs of hemoperitoneum or ischemia.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.19.1″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Spontaneous hematoma, small bowel.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.19.1″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n El hematoma mural espont\u00e1neo de intestino delgado es una entidad rara, que debe sospecharse en pacientes con antecedentes de discrasias sangu\u00edneas o en tratamiento con medicaci\u00f3n anticoagulante, que se presentan con cuadro cl\u00ednico de dolor abdominal. La realizaci\u00f3n de la tomograf\u00eda abdominal con contraste tiene un gran valor diagn\u00f3stico.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.19.1″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Se expuso un caso cl\u00ednico de hematoma mural espont\u00e1neo de intestino delgado, se puntualizaron m\u00e9todos diagn\u00f3sticos y posterior resoluci\u00f3n terap\u00e9utica.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Paciente mujer de 71 a\u00f1os con antecedentes de trombosis venosa profunda en tratamiento cr\u00f3nico con anticoagulantes orales por m\u00e1s de 30 a\u00f1os. Por presentar cuadro infeccioso a nivel de v\u00edas a\u00e9reas superiores se le indico claritromicina 250 mg cada 12 horas v\u00eda oral. Cinco d\u00edas posteriores al comienzo de la ingesta, desarrollo cuadro de dolor abdominal, continuo con exacerbaciones c\u00f3licas a predominio centro abdominal y en hipogastrio por lo cual decidi\u00f3 consultar a urgencias. La paciente se encontraba en buen estado general. Sin signos de respuesta inflamatoria sist\u00e9mica, con dolor centro abdominal, sin defensa. Ruidos hidroaereos conservados. Sin signos de oclusi\u00f3n intestinal.<\/p>\n La anal\u00edtica mostr\u00f3 hematocrito 37%, hemoglobina 12 g\/dl, recuento de plaquetas 482000\/mm3, recuento de gl\u00f3bulos blancos 13800\/mm3, control de coagulaci\u00f3n tiempo de tromboplastina parcial activada con caol\u00edn (KPTT) 89 segundos (valor de referencia 26-36 segundos), tiempo de protombina (TP) 120 segundos tasa 7% (valor de referencia 70-120 %), rango internacional normatizado (RIN) 10.<\/p>\n Se decide la realizaci\u00f3n de tomograf\u00eda axial computada (Figuras 1, 2 y 3).<\/p>\n Con estas im\u00e1genes y la cl\u00ednica de la paciente se decide control m\u00e9dico. En su evoluci\u00f3n desarroll\u00f3 mayor dolor abdominal y agreg\u00f3 v\u00f3mitos. A la palpaci\u00f3n presentaba defensa en hipogastrio y fosa il\u00edaca derecha. Se decide la reversi\u00f3n de su anticoagulaci\u00f3n con plasma fresco congelado y vitamina k y realizaci\u00f3n de video laparoscopia. Por todos estos hallazgos y la evoluci\u00f3n cl\u00ednica de la paciente, se decidi\u00f3 la resecci\u00f3n segmentaria del intestino delgado involucrado con anastomosis. La paciente evolucion\u00f3 favorablemente y fue dada de alta al cuarto d\u00eda postoperatorio.<\/p>\n Anatom\u00eda patol\u00f3gica: [\/et_pb_text][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n El hematoma mural del intestino delgado fue descrito en 1838 por MClaulan, se la relaciona en la gran mayor\u00eda de las veces a la ingesta de drogas anticoagulantes. Los hematomas espont\u00e1neos se producen en el yeyuno (43%), \u00edleon (46%), duodeno (11%), pudiendo ser m\u00faltiples en 2,7 % de los caso.1<\/sup><\/p>\n Se presenta con dolor abdominal, n\u00e1useas y v\u00f3mitos, pudiendo acompa\u00f1ar una hemorragia digestiva en el 35 % de los casos o un verdadero abdomen agudo periton\u00edtico. La ecograf\u00eda puede mostrar un asa de intestino delgado engrosada, con hiperecogenicidad a nivel de la submucosa y disminuci\u00f3n de la peristalsis.3<\/sup> [\/et_pb_text][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n El hematoma mural espont\u00e1neo de intestino delgado es una entidad rara, que debi\u00f3 sospecharse en pacientes con antecedentes de discrasias sangu\u00edneas o en tratamiento con medicaci\u00f3n anticoagulante, que se presentan con cuadro cl\u00ednico de dolor abdominal. [\/et_pb_text][et_pb_text _builder_version=\u00bb4.16″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Los autores declaran no tener conflicto de intereses.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=\u00bb4.16″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb][\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.16″ locked=\u00bboff\u00bb collapsed=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.16″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb][et_pb_text _builder_version=\u00bb4.16″ text_font=\u00bbEB Garamond|700|||||||\u00bb text_text_color=\u00bbrgba(0,0,0,0.02)\u00bb text_font_size=\u00bb80px\u00bb text_line_height=\u00bb0em\u00bb header_2_font=\u00bbEB Garamond||||||||\u00bb header_2_font_size=\u00bb50px\u00bb header_2_line_height=\u00bb1.3em\u00bb text_orientation=\u00bbcenter\u00bb text_font_size_tablet=\u00bb50px\u00bb text_font_size_phone=\u00bb30px\u00bb text_font_size_last_edited=\u00bbon|desktop\u00bb header_2_font_size_tablet=\u00bb40px\u00bb header_2_font_size_phone=\u00bb30px\u00bb header_2_font_size_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n FIGURAS<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.16″ locked=\u00bboff\u00bb collapsed=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.16″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb][et_pb_blurb title=\u00bbFigura 1 – Hallazgos tomogr\u00e1ficos\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Alteraci\u00f3n de la grasa del mesent\u00e9rica segmentaria.<\/p>\n [\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2023\/04\/hematoma-mural-espontaneo1.jpg\u00bb title_text=\u00bbhematoma-mural-espontaneo1″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.20.2″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb][\/et_pb_image][et_pb_blurb title=\u00bb Figura 2 – Hallazgos tomogr\u00e1ficos\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Engrosamiento segmentario de asa de intestino delgado en regi\u00f3n de fosa il\u00edaca derecha.<\/p>\n [\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2023\/04\/hematoma-mural-espontaneo2.jpg\u00bb title_text=\u00bbhematoma-mural-espontaneo\u00bb align=\u00bbcenter\u00bb _builder_version=\u00bb4.20.2″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb][\/et_pb_image][et_pb_blurb title=\u00bb Figura 3 – Hallazgos tomogr\u00e1ficos\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Cambios inflamatorios con realce mucoso y subseroso marcado. Moderada cantidad de l\u00edquido libre a nivel de fondo de saco de Douglas<\/p>\n [\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2023\/04\/hematoma-mural-espontaneo3.jpg\u00bb title_text=\u00bbhematoma-mural-espontaneo3″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.20.2″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb][\/et_pb_image][et_pb_blurb title=\u00bbFigura 4 – Imagen operatoria\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Imagen operatoria que muestra el compromiso segmentario del intestino delgado con su mesenterio correspondiente. En uno de los extremos se visualiza la soluci\u00f3n de continuidad serosa, origen del hemoperitoneo.<\/p>\n [\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2023\/04\/hematoma-mural-espontaneo4.jpg\u00bb title_text=\u00bbhematoma-mural-espontaneo4″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.20.2″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb][\/et_pb_image][et_pb_blurb title=\u00bbFigura 5 – Preparado anatomopatol\u00f3gico de pieza quir\u00fargica\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Corte transversal del intestino delgado donde se aprecia el engrosamiento secundario al hematoma mural. [\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2023\/04\/hematoma-mural-espontaneo5.jpg\u00bb title_text=\u00bbhematoma-mural-espontaneo5″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.20.2″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb][\/et_pb_image][et_pb_blurb title=\u00bbFigura 6 – Preparado histol\u00f3gico\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.20.2″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n Preparado histol\u00f3gico de resecci\u00f3n de intestino delgado con tinci\u00f3n de hematoxilina y eosina. Se visualiza hemorragia transmural disecante desde capa mucosa hacia capa muscular.<\/p>\n [\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2023\/04\/hematoma-mural-espontaneo6.jpg\u00bb title_text=\u00bbhematoma-mural-espontaneo6″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.20.2″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbCourses\u00bb _builder_version=\u00bb4.16″ custom_padding=\u00bb1px|0px|62px|0px|false|false\u00bb collapsed=\u00bbon\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row custom_padding_last_edited=\u00bbon|phone\u00bb _builder_version=\u00bb4.17.4″ background_color=\u00bb#ffffff\u00bb max_width=\u00bb1280px\u00bb custom_padding=\u00bb12px|40px|12px|40px|true|false\u00bb custom_padding_tablet=\u00bb\u00bb custom_padding_phone=\u00bb|20px||20px||true\u00bb animation_style=\u00bbzoom\u00bb animation_intensity_zoom=\u00bb2%\u00bb border_radii=\u00bbon|12px|12px|12px|12px\u00bb box_shadow_style=\u00bbpreset1″ box_shadow_vertical=\u00bb50px\u00bb box_shadow_blur=\u00bb80px\u00bb box_shadow_color=\u00bbrgba(15,19,25,0.1)\u00bb use_custom_width=\u00bbon\u00bb custom_width_px=\u00bb1280px\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.16″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb][et_pb_text _builder_version=\u00bb4.20.2″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb12px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n 1.\tKang EA, Han SJ, Chun J, et al. Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohort study and literature review. Intest Res. 2019[citado 10\/10\/2019];17:135-143. Disponible en: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6361017\/ El hematoma mural espont\u00e1neo de intestino delgado es una entidad rara que debe sospecharse en pacientes con antecedentes de discrasias sangu\u00edneas o en tratamiento con medicaci\u00f3n anticoagulante, que se presenta con cuadro cl\u00ednico de dolor abdominal<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[16,17],"tags":[25],"class_list":["post-1310","post","type-post","status-publish","format-standard","hentry","category-16","category-presentacion-de-casos-clinicos-30","tag-anuario-30-2023"],"_links":{"self":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts\/1310","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/comments?post=1310"}],"version-history":[{"count":8,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts\/1310\/revisions"}],"predecessor-version":[{"id":1399,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts\/1310\/revisions\/1399"}],"wp:attachment":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/media?parent=1310"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/categories?post=1310"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/tags?post=1310"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Fecha de publicaci\u00f3n: 03\/04\/2023<\/p>\nSpontaneous mural hematoma of the small intestine<\/strong><\/h2>\n
Palabras clave<\/h3>\n
Polymorphic ventricular tachycardia after myocardial revascularization surgery<\/strong><\/h2>\n
Abstract<\/h3>\n
Keywords<\/h3>\n
Introducci\u00f3n<\/h3>\n
Objetivos<\/h3>\n
Presentaci\u00f3n del caso<\/h3>\n
En la cirug\u00eda se constata sangre libre en cavidad abdominal (hemoperitoneo). Compromiso de aproximadamente 25 cm de intestino delgado proximal que se encontraba aumentado de tama\u00f1o, con paredes engrosadas e intensamente hiper\u00e9micas. En un segmento de menos de 2 cent\u00edmetros, presentaba colon violeta oscuro, con soluci\u00f3n de continuidad serosa y salida espont\u00e1nea de sangre roja a cavidad abdominal. El meso correspondiente presentaba un hematoma contenido (Figura 4).<\/p>\n
Resecci\u00f3n de intestino delgado con hemorragia transmural disecante de la pared, asociada a exulceraciones y necrosis irregular de la mucosa (infarto). Meso congestivo, hemorr\u00e1gico. No se reconoce trombosis vascular (Figuras 5, 6 y 7).<\/p>\nDiscusi\u00f3n<\/h3>\n
La droga responsable m\u00e1s com\u00fan es la warfarina (81%), seguido por el \u00e1cido acetil salic\u00edlico (13,5%), clopidogrel (2,7%) y heparina de bajo peso molecular (2,7%). Otros factores de riesgo incluyen la hemofilia, p\u00farpura trombocitop\u00e9nica idiop\u00e1tica, insuficiencia hep\u00e1tica, leucemia, linfoma, Von Willebrand, pancreatitis y c\u00e1ncer de p\u00e1ncreas.1, 2<\/sup><\/p>\n
Para el diagn\u00f3stico es importante la sospecha ante la ingesta de anticoagulantes orales. La valoraci\u00f3n del estado de anticoagulaci\u00f3n es clave. Un valor de RIN > 3 se asocia a riesgo de sangrado.<\/p>\n
La tomograf\u00eda axial computada sin contraste es de gran utilidad. Se describe engrosamiento sim\u00e9trico, hiperdenso (50 \u2013 80 UH), de un segmento del intestino delgado que habitualmente no es mayor a los 25 cm, disminuci\u00f3n de la luz y signos indirectos de oclusi\u00f3n intestinal. En los casos que el hematoma haya producido una soluci\u00f3n de continuidad en la serosa, se puede observar l\u00edquido libre en cavidad o hematoma del mesenterio.2,<\/sup>\u00a04<\/sup> La infusi\u00f3n de contraste endovenoso es muy importante para evaluar el estado de los vasos mesent\u00e9ricos ya que uno de los diagn\u00f3sticos diferenciales m\u00e1s importantes de esta patolog\u00eda es la isquemia mesent\u00e9rica. Segmentos cortos con engrosamiento de m\u00e1s de 10 mm de la pared del intestino delgado es caracter\u00edstico de hemorragia intramural.4<\/sup>
Frecuentemente responde bien con tratamiento conservador que consiste en discontinuar las drogas anticoagulantes, ayuno, transfusiones en caso de ser necesario y vitamina k.
En 5 a 7 d\u00edas la cl\u00ednica revierte y en un par de meses se espera que tambi\u00e9n los cambios tomogr\u00e1ficos. Pacientes desnutridos y con antecedentes de accidente cerebro vascular tienen m\u00e1s chances de tener estad\u00edas prolongadas.
El 20 % de los casos los pacientes deben ir a cirug\u00eda. Las razones son: oclusi\u00f3n intestinal, abdomen agudo periton\u00edtico o duda diagn\u00f3stica.<\/p>\nConclusiones<\/h3>\n
La droga responsable m\u00e1s com\u00fan result\u00f3 ser la warfarina (81%) y el sitio m\u00e1s frecuente donde los hematomas espont\u00e1neos se produjeron fue el \u00edleon (46%).
Adem\u00e1s se remarc\u00f3 la importancia de la utilizaci\u00f3n de la tomograf\u00eda sin contraste para su diagn\u00f3stico y seguimiento, ya que habitualmente el tratamiento es conservador.<\/p>\nConflicto de intereses<\/h3>\n
Figuras<\/h2>\n
<\/strong><\/p>\nBibliograf\u00eda<\/h3>\n
\n 2.\tAbbas MA, Collins JM, Olden KW. Spontaneous intramural small-bowel hematoma: imaging findings and outcome. AJR Am J Roentgenol. 2002[citado 01\/02\/2022];179:1389-1394. Disponible en: https:\/\/www.ajronline.org\/doi\/full\/10.2214\/ajr.179.6.1791389
\n 3.\tFrisoli JK, Desser TS, Jeffrey RB, et al. Thickened submucosal layer: a sonographic sign of acute gastrointestinal abnormality representing submucosal edema or hemorrhage. 2000 ARRS Executive Council Award II. AJR Am J Roentgenol. 2000[citado 24\/02\/2000];175:1595-1599. Disponible en: https:\/\/www.ajronline.org\/doi\/pdf\/10.2214\/ajr.175.6.1751595
\n 4.\tMacari M, Chandarana H, Balthazar E, et al. Intestinal ischemia versus intramural hemorrhage: CT evaluation. AJR Am J Roentgenol. 2003[citado 23\/03\/2002];180:177-184. Disponible en: https:\/\/www.ajronline.org\/doi\/pdf\/10.2214\/ajr.180.1.1800177[\/et_pb_text][et_pb_text _builder_version=\u00bb4.16″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"