Idiopathic intramural hematoma of sigmoid colon. A case report

Abstract

Intramural hematoma of the colon is rare. It may be “spontaneous” in patients with anticoagulant therapy or blood dyscrasia or caused by blunt abdominal trauma. An uncertain origin is also reported, so we have also “idiopathic hematoma”. The AA report a new case of uncertain origin and review the literature. The diagnosis is difficult. Symptoms and signs of intestinal obstruction or colic bleeding are often present. Rx plain abdomen and colonoscopy are not diriment. Angio-TC is useful for detailed diagnosis. Resection of colic segment with hematoma is the gold standard therapy, but evacuation of hematoma might be considered. The reported data show that also colic intramural hematoma should be taken into account in cases of colic obstruction or bleeding. This diagnosis should be considered specially in patients with anticoagulant therapy or referred blunt abdominal trauma.