A Case of Intramural Hematoma of the Ascending Colon in a Patient with Myelodysplastic Syndrome and Anticoagulant Therapy

Hemorrhagic shock due to ruptured idiopathic intramural hematoma of the sigmoid colon—An autopsy case report

“…The patient had a history of myelodysplastic syndrome and chronic heart failure, and was warfarinized. The lesion was resected after the patient developed an intramural hematoma of the colon, but he died 34 days after surgery due to heart and respiratory failure [10] .…”

“…Intramural hematomas of the colon are usually found in the submucosal layer [ 6 , 10 , 11 , 17 , 25 ] and muscularis propria [6] . A case of idiopathic bleeding in the inner circular muscle layer has also been reported [21] .…”

“…Surgical treatment is considered the gold standard by some [ 8 , 19 ], while conservative treatment remains the first choice according to others [ 10 , 21 ]. Of course, surgical treatment carries risks in patients on anticoagulant therapy or with underlying blood disorders [10] .…”