NMA/AGSM/2023/PUBH/-Colonic intramural haematoma mimicking strangulated hernia

Abstract

Colonic intramural hematomas are a rarely encountered clinical entity, but important because of their
inclination to cause hemorrhage. The aetiologies may include abdominal trauma, anticoagulant therapy,
or bleeding diathesis such as hemophilia or leukemia. It rarely occurs as an iatrogenic consequence or a
complication of vaginal delivery. The severity of clinical symptoms varies, and includes abdominal pain,
bowel obstruction, lower gastrointestinal bleeding, and haemorrhagic shock amongst others. A 25-year-old male patient presented to our A&E department with 1 1-day history of groin pain and swelling. Clinical
assessment of a strangulated inguinoscrotal hernia was made. All other laboratory investigation parameters
done were within normal limits. The patient was operated on, and the resected bowel was sent for
histopathological analysis. A histological diagnosis of intramural hematoma was made; therefore
entertained as the final diagnosis. We present this rare case, which mimics a strangulated hernia in our
environment. Without the submission of surgical resected tissue, it is very difficult for the surgeon and
pathologist to diagnose this rare disease entity.