Spontaneous intramural small bowel hematoma: unusual cause of intestinal subocclusion in an anticoagulated patient—a case report

SISBH, although rare, should be considered in the differential diagnosis of acute abdominal symptoms in patients receiving long-term oral anticoagulation, particularly with VKAs. Conservative treatment is the preferred initial option. A high index of suspicion, followed by prompt abdominal CT, is key to early diagnosis. PET/CT provided minimal diagnostic value beyond CT. Conservative management with anticoagulation reversal and supportive care is generally the primary therapeutic strategy adopted in the literature, demonstrating favorable short-term outcomes, as was the case with our patient.