Spontaneous intestinal hematoma is a rare complication of anticoagulant therapy. The authors
reported three cases of intramural and submucosal small bowel hematoma resulting from warfarin administration.
The first patient presented with abdominal pain, had intramural hematoma at jejunum, the most
common site of intramural small bowel hematoma. Another patient who had submucosal duodenal hematoma
presented with massive upper gastrointestinal bleeding, a rare manifestation of small bowel hematoma. The
third patient presented with intramural ileal hematoma that caused abdominal pain and palpable mass after
a short period of warfarin therapy. Typical findings on abdominal computerized tomography yielded the
diagnosis. All patients rapidly improved after conservative treatment. The history of anticoagulant use with
prolonged INR value in patients presented with abdominal pain should alert physicians to search for this
entity. It is extremely important to recognize this syndrome in order to avoid an unnecessary operation since
the outcome is usually excellent after conservative treatment.

Keywords: Intramural hematoma, Anticoagulant