Al-Mwald Taha, Mayas Abdullah, Ghabisha Saif A, Al-Wageeh Saleh, Ahmed Faisal
Radiology, Ibb University, Ibb, YEM.
General Surgery, Ibb University, Ibb, YEM.
Cureus. 2023 Dec 30;15(12):e51330. doi: 10.7759/cureus.51330. eCollection 2023 Dec.
Intramural gastrointestinal hematomas are commonly observed following abdominal trauma or are associated with coagulopathy disorders. In contrast, idiopathic gastrointestinal hematoma is rare, and colonic involvement is sporadic, with very few published reports. We report the case of a 29-year-old female who presented with right hypogastric pain over the last three days. Abdominal CT with contrast revealed an 8.5 × 6 × 7.5 cm pre-occlusive intramural hematoma of the ascending colon up to the hepatic flexure with diffuse edematous wall thickening, indicating colonic obstruction. On colonoscopy, the site of the intramural hematoma was identified without active bleeding or obvious pathology, and the colonoscope successfully passed through the region. The patient was managed conservatively. A month later, abdominal CT revealed complete resolution of the colonic hematoma. After two months of follow-up, the patient was free from gastrointestinal symptoms. In conclusion, idiopathic colon intramural hematoma is rare, with a challenge in diagnosis and treatment; efforts should be made to treat it with conservative therapy.
壁内胃肠道血肿常见于腹部创伤后或与凝血功能障碍有关。相比之下，特发性胃肠道血肿罕见，累及结肠的情况散在发生，发表的报告极少。我们报告一例29岁女性病例，该患者在过去三天出现右下腹疼痛。增强腹部CT显示升结肠至肝曲处有一个8.5×6×7.5 cm的闭塞前壁内血肿，伴有弥漫性水肿性肠壁增厚，提示结肠梗阻。结肠镜检查时，确定了壁内血肿的部位，无活动性出血或明显病变，结肠镜成功通过该区域。患者接受保守治疗。一个月后，腹部CT显示结肠血肿完全消退。经过两个月的随访，患者无胃肠道症状。总之，特发性结肠壁内血肿罕见，诊断和治疗具有挑战性；应努力采用保守治疗。
