Obstructive rectal intramural hematoma caused by a foreign body

Abstract

Intramural hematoma of the alimentary tract is a rare condition, which usually results from blunt injury. It can spontaneously occur in patients with coagulopathy or on anticoagulants. Although it may be seen anywhere in the alimentary tract, duodenum is the most common site of the intestinal intramural hematomas. Intramural hematoma caused by a foreign body is rarely seen. Patients with intramural hematoma are usually encountered with obstructive symptoms after an isolated injury. Intramural hematomas are often self-limited at the site of occurrence and can be managed conservatively. They rarely cause progressive obstruction and need surgical drainage. In this article, we report a 51-year-old male patient with foreign body used for masturbation causing rectal intramural hematoma and perforation at the rectosigmoid junction. Because of the intestinal perforation, the patient was managed surgically. In the diagnosis of intramural hematoma of the alimentary tract, beside the clinical history and physical examination, the findings at imaging modalities such as conventional radiography, ultrasonography, and computed tomography are often useful. Patients with rectal intramural hematoma usually do not give diagnostic clues to the physicians in the clinical history. Therefore, radiologists must be familiar with the imaging findings. In this article, we aimed to present a patient with rectal intramural hematoma caused by foreign body and obliterating the rectal lumen.