A Rare Case of Traumatic Colonic Intramural Hematoma in Saudi Arabia

Abstract

Colonic intramural hematomas are rarely encountered clinically. They are most commonly caused by blunt trauma to the abdomen. Diagnosis is usually reached by a combination of a detailed history, physical examination, and radiological investigations. A 14-year-old female patient presented to the emergency department complaining of abdominal pain with a history of a go-karting accident. Upon physical examination, the patient was tachycardic and hypertensive, with right-side abdominal tenderness and fullness. After going through routine radiological investigations, a computed tomography scan showed a large intramural hematoma of the ascending colon measuring around 7.7 x 8.4 x 2 cm. The patient was admitted for conservative management. Throughout her admission, serial examinations were performed, which showed improvement in the patient's condition and the size of the hematoma. The patient was discharged in a stable condition after showing good recovery. Following up with the patient a month later, she was in good condition with no active complaints, and an ultrasound was done that revealed complete resolution. To our understanding, this report of colonic intramural hematoma caused by the unusual etiology of the go-karting accident, which was successfully managed conservatively, adds significantly to the literature.

Keywords: colon; conservative; ct with contrast; intramural hematoma; trauma.

Figure 1. Abdominal contrast-enhanced CT images

(A) Axial view revealed a hyperdense mass in the ascending colon (white arrow). (B) Sagittal view showing a hematoma at the ascending colon (white arrow). (C) Frontal view

Figure 2. Ascending colon ultrasound revealing a colonic intramural hematoma