Farmacologia Cardiovascular: Acesso Aberto

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Abdominal Wall and Intra Pelvic Hematoma Presenting as Abdominal Pain after Short Course of Antibiotics in Patients on Long Term Warfarin Therapy

Kandegedara Ruwana Munasinghe, Gallage Chandima Amarasena, Naomali Lalani Amarasena,Jagath Indranath Parakrama Herath and Harshana Dilan Samarasinghe

Warfarin is the most commonly used anticoagulant in clinical practice. Despite its advantages it has serious side effects mainly bleeding due to narrow therapeutic range and several drug and food interactions. Spontaneous abdominal haemorrhage is one of the rare bleeding manifestations of it. Concomitant use of commonly used antibiotic are associated with an increased risk of bleeding among patients receiving warfarin. We report two patients who presented with abdominal pain, later confirmed as abdominal wall and intraabdominal hematoma by computed tomography of abdomen. Both of them were had concomitant use of antibiotics along with warfarin prior to this clinical presentation. We highlight the importance of making a high degree of suspicion on abdominal haemorrhage in patients with warfarin treatment when presented as abdominal abdomen. We also emphasized the consideration of drug interaction of warfarin before prescribing other medication as well as close monitoring of INR during that period