Massive colonic haematoma following blunt trauma sustained playing rugby

Abstract

A case is presented of a 24-year-old man who sustained a forceful blow to the right side of the abdomen during a tackle while playing rugby union. The patient was thought to be "winded" and could not play on. He sought medical attention several hours later at the local hospital where initial evaluation revealed mild right iliac fossa tenderness with no signs of peritonism and clinical parameters showed haemodynamic stability. Subsequent ultrasound and CT evaluation revealed a large haematoma involving the caecum and ascending colon. Emergency right haemicolectomy with primary anastomosis was performed to remove the large haematoma within the intact colonic wall. He was observed in the high dependency unit and was discharged after 7 days following an uneventful postoperative course. He continues to make significant progress some 3 months later and a full return to contact sport is being proposed within 9-12 months.

Figure 1

Large (18×9×9 cm) haematoma within the ascending colonic wall with some small areas (opacities) denoting an acute bleeding.

Figure 2

Large (18×9×9 cm) haematoma within the ascending colonic wall with some small areas (opacities) denoting an acute bleeding.