Kubo Kimitoshi, Kimura Noriko, Hanyu Noriaki, Haraguchi Koichi
Departments of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Japan.
Departments of Pathology, National Hospital Organization Hakodate National Hospital, Hakodate, Japan.
Case Rep Gastroenterol. 2022 May 30;16(2):339-344. doi: 10.1159/000524793. eCollection 2022 May-Aug.
Colonic intramural hematoma is a rare condition and its endoscopic and radiological findings remain poorly described. An 82-year-old woman was hospitalized with a diagnosis of acute cerebral infarction. She immediately received anticoagulant therapy with argatroban for 1 week. With the appearance 4 days later of hematochezia, she was found to have severe anemia. Following insertion of the colonoscope, a large submucosal hematoma was shown to be present in the descending colon, with the mucosa shown to be necrotic and the residual mucosa around the hematoma shown to be yellowish. Computed tomography revealed a hyperdense mass in the descending colon. Laparoscopic colectomy was performed for the lesion diagnosed as intramural hematoma. Pathologically, it was a hematoma located in the subserosal layer involving full-thickness hemorrhage. To our knowledge, this report represents a valuable addition to the literature describing a case of colonic intramural hematoma whose diagnosis was effectively established by the combined use of CS and CT.
结肠壁内血肿是一种罕见病症，其内镜和放射学表现仍鲜有描述。一名82岁女性因急性脑梗死入院。她立即接受了阿加曲班抗凝治疗1周。4天后出现便血，发现她患有严重贫血。插入结肠镜后，发现降结肠存在一个大的黏膜下血肿，黏膜坏死，血肿周围残留黏膜呈淡黄色。计算机断层扫描显示降结肠有一个高密度肿块。对诊断为壁内血肿的病变进行了腹腔镜结肠切除术。病理检查显示，这是一个位于浆膜下层的血肿，伴有全层出血。据我们所知，本报告为文献增添了有价值的内容，描述了一例通过结肠镜检查（CS）和计算机断层扫描（CT）联合使用有效确诊的结肠壁内血肿病例。
