Submucous Traumatic Rectal Hematoma Treated Conservatively

El-Ashaal, Yousef; Abou-Rebyeh, H.; Saadeldin, Yousif A.; Abu‐Zidan, Fikri M.

doi:10.1097/ta.0b013e3181c52796

Cited by 2 publications

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“…Submucosal hematoma has been previously described in the literature as an adverse side effect of anticoagulation therapy, but never as a caustic injury complication [ 16 ]. It was commonly treated with a medical procedure when present [ 17 ]. Tohda et al [ 12 ] described in patients with strong alkalis induced grade II lesions, the endoscopic signs of blisters or frank hemorrhage, contrasting with grey or black coagulation necrosis.…”

Section: Discussionmentioning

confidence: 99%

Submucosal hematoma: a new distinctive sign during emergency upper digestive endoscopy for ammonia ingestion

Gelu-Siméon

Chuong²,

Saliba

et al. 2018

BMC Gastroenterol

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BackgroundSubmucosal hematoma has never been associated with caustic injuries. Long-term follow-up of patients who ingested ammonia is not well known and ammonia ingestion is rare.MethodsIn a Single-center observational study, prospective data were collected from 2009 to 2013, in patients over the age of 14 years old referred for ammonia ingestion. The emergency and follow-up endoscopic data and the outcome were reported.ResultsAmmonia ingestion occurred in 43 patients. Submucosal hematoma of the gastric wall was a distinctive endoscopic sign observed in 15 (34.8%) cases. Oropharyngeal lesions were present in 30 (69.8%) patients, which was associated with ingestion with suicidal intent in 18 cases. Mild and severe endoscopic lesions (grade IIB to IIIB) were found in 16 (37.2%) cases with 10 (23.3%) cases presenting submucosal hematoma at initial endoscopy. A complete spontaneous gastric healing was frequently observed in 36 (83.7%) cases. In 11 cases with submucosal hematoma, a favourable outcome was observed with a medical treatment, however 6 of these patients had severe endoscopic lesions initially.ConclusionsSubmucosal hematoma of the gastric wall is an endoscopic sign occurring frequently in ammonia ingestion. Submucosal hematoma should be distinguished from necrosis in order to avoid false misclassification in favour of more severe lesions, which would lead to an abusive surgery.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0809-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Submucosal hematoma: a new distinctive sign during emergency upper digestive endoscopy for ammonia ingestion

Gelu-Siméon

Chuong²,

Saliba

et al. 2018

BMC Gastroenterol

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“…Clinical features may be insidious, although shock following extension into the abdominal retroperitoneum has also been reported 2. Furthermore, compression of neurovascular structures passing in the presacral space may cause radiculopathy and paradoxical incontinence 3. A delayed clinical feature is ecchymosis in the juxtaposed tissues; this may be a useful clue in the absence or delay of radiological diagnosis by CT scanning 2.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous presacral haematoma mimicking rectal malignancy - an unusual consequence of anticoagulation

Antonowicz²,

Menon³

2012

Case Reports

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An 81-year-old man on warfarin was admitted to hospital after 3 days of constipation, straining and mild rectal bleeding. A large, boggy mass was felt posteriorly on direct rectal examination. Investigations revealed a normocytic anaemia and a supratherapeutic international normalised ratio (INR). Fearing a late presentation of malignancy, an urgent CT of abdomen and pelvis was arranged which showed a homogeneous mass arising between the sacrum and the rectum. Given the anaemia in the presence of anticoagulation, and subsequent widespread perineal and scrotal ecchymosis, the patient was diagnosed with atraumatic presacral haematoma. Following resuscitation, the patient was managed non-operatively and was discharged several days later following stabilisation of the haemoglobin and INR. At 3 months, he had complete clinical and radiological resolution of this haematoma.

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Submucous Traumatic Rectal Hematoma Treated Conservatively

Cited by 2 publications

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Submucosal hematoma: a new distinctive sign during emergency upper digestive endoscopy for ammonia ingestion

Submucosal hematoma: a new distinctive sign during emergency upper digestive endoscopy for ammonia ingestion

Spontaneous presacral haematoma mimicking rectal malignancy - an unusual consequence of anticoagulation

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