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Colonic Perforation Secondary to Idiopathic Intramural Hemorrhage

대한대장항문학회지 2016년 32권 6호 p.239 ~ 242
 ( Sakamoto Takashi ) - Tokyo Bay Urayasu Ichikawa Medical Center Department of Surgery

 ( Saito Akira ) - Tokyo Bay Urayasu Ichikawa Medical Center Department of Pathology
 ( Lefor Alan Kawarai ) - Jichi Medical University School of Medicine Department of Surgery
 ( Kubota Tadao ) - Tokyo Bay Urayasu Ichikawa Medical Center Department of Surgery

Abstract


Intramural colonic hemorrhage is rare and often secondary to trauma or anticoagulation therapy. Idiopathic intramural hemorrhages in the alimentary tract have rarely been reported. While several reports of spontaneous perforation of an intramural rectal hematoma have been published, no reports of spontaneous perforation in the ascending colon due to a hematoma have. We describe a patient with an ascending colonic perforation secondary to spontaneous intramural hemorrhage. The patient is a 35-year-old male, who presented with acute abdominal pain and no history of trauma. An abdominal computed tomography scan showed a high-density area around the ascending colon, and nonoperative management was instituted. On the eighth hospital day, the pain worsened, and abdominal computed tomography scan showed free air. An emergent right hemicolectomy was performed. Intramural hematoma and ischemia with perforation, with no obvious etiology, were found. The patient was discharged on the 14th postoperative day.

키워드

Intramural hemorrhage; Colon; Perforation
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