1996 Volume 7 Issue 6 Pages 292-296
This is a report of a case of intramural hematoma and necrosis of the sigmoid colon in a patient with myelodysplastic syndrome (MDS). The patient is a 77-year-old man diagnosed with MDS ten months prior to the development of this condition. He consulted a physician because of left lower abdominal pain and was referred to us with a tentative diagnosis of impending rupture of an abdominal aortic aneurysm. He had anemia, leukocytosis and thrombocytopenia. CT scan showed an abdominal aortic aneurysm and an enlarged sigmoid colon. The patient received platelet transfusions and was operated on 30 hours after the onset of symptoms. A 20-cm length of sigmoid colon was found to be was necrotic, and the affected segment of bowel was resected with sufficient margins and end-to-end anastomosis was performed. A submucosal hematoma was discovered, and a diagnosis of non-traumatic intramural hematoma and necrosis of the sigmoid colon was made. The patient resumed oral food intake uneventfully and was discharged 155 days after the operation. CT scanning was helpful in establishing the diagnosis of a rare intramural hematoma of the colon in our patient. MDS was suspected to have played a major role in the pathogenesis.
