Intramural hematoma of the cecum: report of two cases.

Abstract

Intramural hematoma of the cecum is a rare complication of blunt abdominal trauma. We report two patients who presented with cecal hematoma after a fall and a traffic accident, respectively. Diagnosis was by abdominal computed tomographic scan. Patients were operated on 24 and 36 hours after the injury because of sudden clinical deterioration and hemoperitoneum, respectively. The patients had a large cecal intramural hematoma that progressed to the ascending colon by dissection of the teniae coli. Emergency right hemicolectomy was followed by uneventful recovery in both patients. Only six previously reported cases of cecal intramural hematoma were found, and in all cases a right hemicolectomy was performed. In conclusion, in contrast to hematomas located in other sections of the gastrointestinal tract, early surgical treatment for intramural hematoma of the cecum is recommended.