RESUMEN
Anticoagulant-induced spontaneous small bowel hematoma is a rare cause of acute mechanical bowel obstruction. We report the case of a 77-year-old patient with complete arrhythmia due to atrial fibrillation under acenocoumarol 4mg daily who was seen for right iliac fossa pain. The laboratory tests showed a prothrombin rate (PT) of 12%, an International Normalized Ratio (INR) of 6, and an aPTT (activated partial thromboplastin time) of 43 seconds. Abdominopelvic ultrasound showed an echogenic pelvic effusion. The diagnosis of the small hematoma was made by abdominopelvic CT scan, which showed a thickening of the small bowel wall reducing its caliber associated with a parietal hematoma . The evolution was unremarkable under supplementation therapy vitamin K.
RESUMEN
Atypical fibromuscular dysplasia of the bulb or carotid web is a nonatheromatous pathology more common in African and African-American populations. It is implicated in the occurrence of cerebral infarcts of unknown causes. Its diagnosis is made by angio-CT of the supra-aortic trunks and is characterized by a defect in the posterior wall of the bulb. Treatment with antiplatelet agents prevents the occurrence of stroke, but radical treatment remains surgical and endovascular. We report 2 observations of carotid web diagnosed and medically managed at the regional hospital of Saint Louis.