Rectal colonic mural hematoma following enema for constipation while on therapeutic anticoagulation.

Causes of colonic and recto-sigmoid hematomas are multifactorial. Patients can present with a combination of dropping hemoglobin, bowel obstruction and perforation. Computed tomography imaging can provide clues to a diagnosis of intramural hematoma. We present a case of rectal hematoma and a review of current management literature. A 72-year-old male on therapeutic anticoagulation for a pulmonary embolism, was administered an enema resulting in severe abdominal pain unresponsive to blood transfusion. A sigmoid colectomy with end colostomy was performed. Although rare, colonic and recto-sigmoid hematomas should be considered as a possible diagnosis for adults with abdominal pain on anticoagulant therapy. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2017.

Citation

Rebecca M Rentea, Charles H Fehring. Rectal colonic mural hematoma following enema for constipation while on therapeutic anticoagulation. Journal of surgical case reports. 2017 Jan 19;2017(1)

PMID: 28108634

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