[Intestinal occlusion caused by an intramural ileo-cecal-colonic hematoma during treatment with oral anticoagulants]. / Occlusione intestinale da ematoma intramurale ileo-cieco-colico in corso di trattamento con anticoagulanti orali.

The Authors report a case of bowel occlusion due to intramural ileocecocolic haematoma in a patient in treatment with oral anticoagulants. This case is interesting both to unusual etiology correlated to the localization and because there are many concomitant pathogenetic factors; this case was treated on urgency by bowel resection and it had a good prognosis. The Authors discuss the diagnostic and therapeutic difficulties and conclude that in patients with anticoagulant oral therapy an accurate clinical follow-up is required.

[Internal abdominal hernia. Unusual cause of intestinal occlusion]. / Ernia addominale interna. Una insolita causa di occlusione intestinale.

Internal abdominal hernias are an unusual cause of intestinal occlusion. They are responsible for 2% of all the intestinal obstructions. Various types of hernia have been described. The diagnosis is difficult, but should be suspected in patients suffering from intestinal obstruction who have undergone earlier laparotomy. Diagnosis is even more difficult in cases of congenital internal hernia. The authors report a case of left paraduodenal hernia (congenital), and a case of transmesenteric hernia (acquired). Both patients complained of a short history of abdominal pain and characteristic symptoms of acute abdomen (nausea, vomit, cramps and obstipation). Emergency surgery using laparotomy enabled diagnosis and treatment. The authors underline the difficulty of diagnosing these hernias and emphasise the diagnostic and therapeutic importance of emergency surgery.