Acute colonic intramural hematoma due to blunt abdominal trauma

Trauma to the colon is uncommon and accounts for only 3-5% of all blunt abd ominal injuries. Among them, intramural hematoma of the colon is a rare com plication and the acute form is rarer than the chronic form. We report a 37 -year-old man who presented with abdominal pain followed by intestinal obst ruction due to a blunt trauma. The initial diagnosis was done by sonography and proved by computed tomography (CT). Abdominal sonography also detected an increment in the size of the hematoma with progressive abdominal crampi ng pain that prompted urgent laparotomy. Ileocolic segmental resection with end-to-end ileocolostomy was performed and the patient recovered uneventfu lly. Based on our experience with a patient suffering from an intramural co lonic hematoma following blunt abdominal trauma (BAT) and based on a review of the literature, we discuss the different clinical manifestations, diffi culties of diagnosis, and different treatment modalities of this disease en tity. We conclude that acute colonic hematoma can be diagnosed by sonograph y and/or CT in contrast to the early reported cases, in the pre-CT era, whe n they could only be diagnosed at laparotomy. Endoscopy may also be helpful for diagnosis in some eases. Although expectant therapy may be successful in some cases, the majority of the cases may need operation.