A Case of Idiopathic Intramural Hematoma of the Colon That Presented as an Abdominal Tumor

Abstract

A 69-yaer-old woman with no previous history of trauma was admitted to our hospital with lower abdominal pain. Enhanced abdominal CT showed a mass measuring 86 mm in diameter, with internal bleeding. MRI revealed the mass as being mainly a hematoma compressing the sigmoid colon. We suspected that the mass was an ovarian tumor with internal bleeding, and laparotomy was performed with gynecologists in attendance on day 5 of hospitalization. The operative findings revealed a fist-sized tumor that extended from behind the sigmoid colon to the sigmoid mesocolon, with massive bloody ascites; the gynecological organs were normal. Sigmoidectomy was performed. Histopathological examination revealed a subserosal hematoma not associated with a malignant tumor or vessel malformation. We diagnosed the patient as having an idiopathic intramural hematoma in the sigmoid colon, as there were no history of trauma or hemorrhagic disorder. Colonic idiopathic intramural hematoma is a relatively rare disease entity, and in most cases, it is caused by trauma or antithrombotic drug treatment. Ours is 7th case report in the literature of idiopathic intramural hematoma.