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A 79-year-old woman who was taking warfarin and enoxaparin because of deep venous thrombosis reported abdominal pain after coughing. On physical examination, a mass was felt in the left side of the abdomen. Computed tomography (CT) showed blood in the left rectus sheath, with thickening of the left upper abdominal wall, and a fluid–fluid level (arrowhead) within a mass (arrow) in the midabdomen (Panel A). The hemoglobin level was 9.7 g per deciliter, and the prothrombin time was 24.9 seconds (international normalized ratio, 3.3). Anticoagulant treatment was discontinued, but the mass enlarged, and three days later CT scanning showed extension . . . [Full Text of this Article] |
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