Clinical Journal of Gastroenterology

, Volume 2, Issue 3, pp 161–165 | Cite as

Idiopathic spontaneous intramural hematoma of the colon: a case report and review of the literature

  • Tsukasa NozuEmail author
Case Report


An 82-year-old man visited our hospital for abdominal discomfort and constipation lasting 3 days. He did not have a history of trauma or bleeding tendency. His laboratory studies showed slight anemia and inflammatory reactions, but other data including coagulation profiles were all normal. Computed tomography (CT) demonstrated a 6-cm high-density mass in the left upper quadrant and slight ascites. Contrast-enhanced CT revealed that the lesion was not enhanced. Colonoscopy could not detect the lesion. Laparotomy was performed because malignancy could not be ruled out. The mass was located in the transverse colon, and histologic examination showed intramural hematoma. Neither arteriovenous malformation nor a foreign body such as a fish bone was identified, indicating that the mass was considered to be idiopathic intramural colonic hematoma. We present this rare case and also a review of the literature.


Intramural hematoma Idiopathic Colon CT 


  1. 1.
    Hughes CE, Conn J, Sherman JO. Intramural hematoma of the gastrointestinal tract. Am J Surg. 1977;133:276–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Umeda I, Ohta H, Doi T, Nobuoka A, Kanisawa Y, Kawasaki R, et al. Idiopathic intramural hematoma of the colon. Gastrointest Endosc. 2007;66:861–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Jarry J, Biscay D, Lepront D, Rullier A, Midy D. Spontaneous intramural haematoma of the sigmoid colon causing acute intestinal obstruction in a haemophiliac: report of a case. Haemophilia. 2008;14:383–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Schiller M, Morse TS, Frye TR. Severe rectal bleeding from an intramural hematoma of the sigmoid. Pediatrics. 1971;48:146–8.PubMedGoogle Scholar
  5. 5.
    Pates DR, Shrivastav R, Hand G. Intestinal obstruction due to intramural hematoma of the colon, a complication of sodium warfarin therapy: report of a case. Dis Colon Rectum. 1973;16:416–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Calenoff L, Lounsbury F. Intramural hematoma of the sigmoid. Am J Roentgenol Radium Ther Nucl Med. 1969;107:170–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Harrison HC, Lord RS, Chesterman CN, Biggs JC, Tracy GD. Spontaneous intramural haematoma in the sigmoid colon of a haemophiliac. Aust N Z J Surg. 1972;42:69–70.CrossRefPubMedGoogle Scholar
  8. 8.
    Nakayama Y, Fukushima M, Sakai M, Hisano T, Nagata N, Shirahata A, et al. Intramural hematoma of the cecum as the lead point of intussusception in an elderly patient with hemophilia A: report of a case. Surg Today. 2006;36:563–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Kratzer GL, Dixon CF. Traumatic submucosal hematoma of the midportion of the ascending colon; report of case. Proc Staff Meet Mayo Clin. 1951;26:18–20.PubMedGoogle Scholar
  10. 10.
    Adams-Ray J, Sundstrom KA. Stenosing hematoma of the colon, possibly due to testa of pea lodged in the intestinal wall: a case report. Acta Chir Scand. 1955;108:398–401.PubMedGoogle Scholar
  11. 11.
    Westcott JL, Smith JR. Mesentsery and colon injuries secondary to blunt trauma. Radiology. 1975;114:597–600.CrossRefPubMedGoogle Scholar
  12. 12.
    Kahn A, Vandenbogaert N, Cremer N, Fondu P. Intramural hematoma of the alimentary tract in two hemophilic children. Helv Paediatr Acta. 1977;31:503–7.PubMedGoogle Scholar
  13. 13.
    Yoshida T, Kanbe H, Haraguchi Y, Sakamoto A, Iwashita T, Tanaka K, et al. Submucosal hematoma producing mechanical obstruction in the sigmoid colon, complicated by systemic amyloidosis. Endoscopy. 1983;15:277–80.CrossRefPubMedGoogle Scholar
  14. 14.
    Welling RE, Reilly PS. Nonoperative treatment of a traumatic intramural hematoma of the ascending colon. South Med J. 1986;79:1309–10.CrossRefPubMedGoogle Scholar
  15. 15.
    Karjoo M, Domachowske J, Trust S. Intramural hematoma of the descending colon after blunt abdominal trauma. Clin Pediatr (Phila). 2000;39:373–4.CrossRefGoogle Scholar
  16. 16.
    Jeffrey RB, Federle MP, Stein SM, Crass RA. Case report. Intramural hematoma of the cecum following blunt trauma. J Comput Assist Tomogr. 1982;6:404–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Vollmer CM Jr, Schmieg RE, Freeman BD, Balfe DM. Traumatic colonic hematoma. J Trauma. 2000;49:1155.CrossRefPubMedGoogle Scholar
  18. 18.
    Yin WY, Gueng MK, Huang SM, Chen HT, Chang TM. Acute colonic intramural hematoma due to blunt abdominal trauma. Int Surg. 2000;85:51–4.PubMedGoogle Scholar
  19. 19.
    Calabuig R, Ortiz C, Sueiras A, Vallet J, Pi F. Intramural hematoma of the cecum: report of two cases. Dis Colon Rectum. 2002;45:564–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Parizel PM, Makkat S, Van Miert E, Van Goethem JW, van den Hauwe L, De Schepper AM. Intracranial hemorrhage: principles of CT and MRI interpretation. Eur Radiol. 2001;11:1770–83.CrossRefPubMedGoogle Scholar
  21. 21.
    Sachdeva RS, Jaeger A, Norton K, Raucher H, Dolgin SE, Benkov K, et al. Intramural hematoma of the transverse colon in battered child syndrome. J Pediatr Gastroenterol Nutr. 1994;18:111–3.CrossRefPubMedGoogle Scholar
  22. 22.
    Sousa C, Pedroto I, Campos M, Pinho C. Spontaneous hematoma of the colon. Endoscopy. 2000;32:S74.PubMedGoogle Scholar
  23. 23.
    Hess RA. Intramural hematoma of the transverse colon with obstruction and possible impending gangrene: report of a case associated with acute hemorrhagic cholecystitis. Am Surg. 1964;30:138–40.PubMedGoogle Scholar
  24. 24.
    Richards M, Jarvis MJ, Thompson N, Wadsworth ME. Cigarette smoking and cognitive decline in midlife: evidence from a prospective birth cohort study. Am J Public Health. 2003;93:994–8.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Nance FC, Crowder VH. Intramural hematoma of the colon following blunt trauma to the abdomen. Am Surg. 1968;34:85–7.PubMedGoogle Scholar
  26. 26.
    Stewart DR, Byrd CL, Schuster SR. Intramural hematomas of the alimentary tract in children. Surgery. 1970;68:550–7.PubMedGoogle Scholar
  27. 27.
    Wynn TE. Endometriosis of the sigmoid colon. Massive intramural hematoma. Arch Pathol. 1971;92:24–7.PubMedGoogle Scholar
  28. 28.
    Esposito JM. Hematoma of the sigmoid colon as a complication of laparoscopy. Am J Obstet Gynecol. 1973;117:581–2.CrossRefPubMedGoogle Scholar
  29. 29.
    Berezin S, Glassman MS, Slim MS, Newman LJ. Colonic hematoma after blunt abdominal trauma. J Pediatr Gastroenterol Nutr. 1992;15:100–2.CrossRefPubMedGoogle Scholar
  30. 30.
    Dixon E, Steed B, Sutherland F, Mitchell P. Soft-tissue case 32. Right colonic intramural hematoma. Can J Surg. 2000;43(90):112.Google Scholar

Copyright information

© Springer 2009

Authors and Affiliations

  1. 1.Department of Internal MedicineShari General HospitalShariJapan

Personalised recommendations