Giant Intramural Hematoma of the Colon in Acquired Factor VIII Inhibitor

Authors

  • Joana Figueiredo Department of General Surgery. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Nuno Borges Department of General Surgery. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • José Pascoalinho Department of General Surgery. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Ricardo Matos Department of General Surgery. Centro Hospitalar Universitário de Lisboa Central. Lisboa.

DOI:

https://doi.org/10.20344/amp.8519

Keywords:

Colon, Hematoma, Hemophilia A, Factor VIII

Abstract

Intramural hematoma of the colon is very rare, particularly when associated with the development of autoantibodies against factor VIII.
We report a case of a 66-year-old man with abdominal pain, hematochezia and clots in the left colon, without any radiologic signs of active bleeding or bowel occlusion or analytical changes in routine coagulation screening, but with positive autoantibodies against factor VIII. The clinical instability prompted surgical exploration. An intramural hematoma of the left colon was found, and a left colectomy was performed. The patient was treated with hemoderivatives and corticosteroids with clinical improvement. The diagnosis of spontaneous intramural hematoma might be a challenge, particularly in the absence of clinical suspicion. An early recognition is essential for a positive outcome. This case highlights a rare cause of bleeding and intestinal obstruction, but also the difficulty and relevance of establishing a clinical diagnosis when diagnostic tests are not completely informative.

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Published

2019-09-02

How to Cite

1.
Figueiredo J, Borges N, Pascoalinho J, Matos R. Giant Intramural Hematoma of the Colon in Acquired Factor VIII Inhibitor. Acta Med Port [Internet]. 2019 Sep. 2 [cited 2024 Nov. 13];32(9):614-7. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/8519

Issue

Section

Case Report