A 78-year-old woman was brought to the Emergency Department with sudden onset of a painful swollen mass in the right abdominal wall. She had chronic atrial fibrillation and a history of acute arterial occlusion of the right lower leg and underwent catheter embolectomy 3 years prior to this incident. She was maintained on warfarin therapy postoperatively. On examination, a 15 × 10-cm tender ecchymotic mass was detected in the right lower quadrant of the abdomen. The laboratory test revealed anemia (Hb 9.9 g/dL) and prolonged prothrombin time (INR prolonged to 3.3). A computed tomography (CT) scan of the abdomen showed a huge hematoma with a “fluid-fluid” level in it (Figure 1). Because of persistent pain and failed needle aspiration, surgical decompression was performed after correcting the prothrombin time. The postoperative course was uneventful, and she was discharged 7 days after operation.
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Accepted: August 9, 2000
Received: May 11, 2000
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.