抗凝固療法中に発症した小腸壁内血腫の2例

Two cases of small bowel intramural hematoma induced by anticoagulation therapy

小腸壁内血腫はまれな疾患であり，非外傷性例では抗凝固療法によるものが最多である。我々は抗凝固療法中に発症した小腸壁内血腫を2例経験した。1例は手術加療を施行し，1例は保存的加療を施行した。線溶系亢進下での手術はリスクが高く，小腸壁内血腫と診断できれば手術を回避できる場合もある。小腸壁内血腫について画像所見と文献的考察を交えて報告する。

Small bowel intramural hematoma is a rare disease, and it is most frequently induced by anticoagulation therapy, especially warfarin. We have had experience with two patients with small bowel intramural hematoma. One was treated with a surgical procedure, and the other was treated with conservative therapy. Their CT scans showed characteristic findings, which were marked circumferential thickening of the small bowel wall, hyperdense intramural hematoma, and blood ascites. Surgical treatment can be avoided if a definitive diagnosis of small bowel intramural hematoma can be made. Herein we report two cases with image findings and some literature review.