Intramural hematoma of the cecum: report of two cases
Ricard Calabuig1, Carles Ortiz, Albert Sueiras
1Department of Surgery, Hospital de Viladecans, Barcelona, Spain.
Insights
Intramural hematoma of the cecum is a rare injury from blunt abdominal trauma. Early surgical intervention is recommended for cecal hematoma due to potential complications.
Area of Science:
- Gastroenterology
- Trauma Surgery
Background:
- Intramural hematoma of the cecum is a rare complication of blunt abdominal trauma.
- This condition can lead to significant morbidity if not managed appropriately.
Observation:
- Two patients presented with cecal hematoma following blunt abdominal trauma (fall and traffic accident).
- Diagnosis was confirmed via abdominal computed tomographic (CT) scan.
- Both patients underwent emergency right hemicolectomy due to clinical deterioration and hemoperitoneum.
Findings:
- The patients exhibited large cecal intramural hematomas extending into the ascending colon.
- Surgical management involved right hemicolectomy, resulting in uneventful recovery for both individuals.
- A review of existing literature identified only six previously reported cases of cecal intramural hematoma, all treated with right hemicolectomy.
Implications:
- Early surgical treatment for intramural hematoma of the cecum is advised, differentiating it from hematomas in other gastrointestinal tract locations.
- This case series contributes to the limited understanding of cecal intramural hematoma management.
- Prompt surgical intervention may prevent complications such as perforation or extensive dissection.
Abstract:
Intramural hematoma of the cecum is a rare complication of blunt abdominal trauma. We report two patients who presented with cecal hematoma after a fall and a traffic accident, respectively. Diagnosis was by abdominal computed tomographic scan. Patients were operated on 24 and 36 hours after the injury because of sudden clinical deterioration and hemoperitoneum, respectively. The patients had a large cecal intramural hematoma that progressed to the ascending colon by dissection of the teniae coli. Emergency right hemicolectomy was followed by uneventful recovery in both patients. Only six previously reported cases of cecal intramural hematoma were found, and in all cases a right hemicolectomy was performed. In conclusion, in contrast to hematomas located in other sections of the gastrointestinal tract, early surgical treatment for intramural hematoma of the cecum is recommended.
