Chaudhary Bikash, Yadav Alisha, Mahato Abhishek, Deo Aakash, Ghimire Bikal, Kansakar Prasan Bir Singh
Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
Maharajgunj Medical Campus, Institute of Medicine, Nepal.
Int J Surg Case Rep. 2025 Feb;127:110966. doi: 10.1016/j.ijscr.2025.110966. Epub 2025 Jan 30.
Occurrence of intramural jejunal hematoma is rare condition, mostly seen among patients with bleeding disorders, warfarin toxicity and abdominal trauma. It is seen mostly among children than adults. In this report, we present a case of jejunal hematoma that occurred following a minor abdominal trauma. The incidence of jejunal hematoma as a result of trauma is exceedingly uncommon.
We present a case of 48-year-male with history of abdominal trauma one year back presented with features of intestinal obstruction. Abdominal CT scan revealed intestinal obstruction at the level of the jejunum and was planned for surgery. During exploratory laparotomy, blood was seen in the peritoneum with the hemorrhagic mass at the jejunum. Resected specimen was sent for histopathology which showed hematoma involving submucosa, muscular, and peri-muscular fibrous tissue. Hence the diagnosis of jejunal hematoma was made.
Jejunal hematoma following trauma is a rare condition as compared to duodenal hematoma due to its relatively fixed position. Here in our case, abdominal trauma is the probable cause of jejunal hematoma. The symptoms range from mild abdominal pain to intestinal obstruction with acute abdomen. A coagulation profile should be done to rule out bleeding disorders which is one of the common causes of jejunal hematoma.
This rare case report guides healthcare professionals to include jejunal hematoma as a differential for a patient presenting with the symptoms of intestinal obstruction.
空肠壁内血肿是一种罕见病症，多见于患有出血性疾病、华法林中毒及腹部创伤的患者。相较于成人，儿童更为多见。在本报告中，我们呈现了一例因轻微腹部创伤后发生的空肠血肿病例。因创伤导致空肠血肿的发生率极为罕见。
我们报告一例48岁男性，有一年前腹部创伤史，现出现肠梗阻症状。腹部CT扫描显示空肠水平肠梗阻，计划进行手术。在剖腹探查术中，可见腹膜内有血液，空肠处有出血性肿块。切除标本送组织病理学检查，结果显示血肿累及黏膜下层、肌肉层及肌周纤维组织。由此确诊为空肠血肿。
与十二指肠血肿相比，创伤后空肠血肿较为罕见，因为空肠位置相对固定。在我们的病例中，腹部创伤可能是空肠血肿的病因。症状从轻度腹痛到伴有急腹症的肠梗阻不等。应进行凝血功能检查以排除出血性疾病，出血性疾病是空肠血肿的常见病因之一。
这份罕见病例报告指导医疗保健专业人员将空肠血肿列为出现肠梗阻症状患者的鉴别诊断之一。
