Findings
-The proximal small bowel is enlarged with high-density intramural thickening and regularly thickened folds.
-The stomach is dilated with normal wall thickness. The distal small bowel is normal in caliber.
Discussion
This patient overdosed on coumadin and the findings are due to a mural hemorrhage in the duodenum and proximal jejunum causing partial gastric outlet obstruction.
http://eradiology.bidmc.harvard.edu/Classics/item.aspx?section=Emergency+Radiology&labelpk=33f0adab-853f-4010-a0e2-0756b3f1eac5&pk=2ff7119e-48ac-4e6b-b6b3-9b73cddf1791
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