Intramural jejunal hematoma following abdominal trauma as a rare cause of small bowel obstruction in an adult male: A case report.

Abstract

Introduction and importance: Occurrence of intramural jejunal hematoma is rare condition, mostly seen among patients with bleeding disorders, warfarin toxicity and abdominal trauma. It is seen mostly among children than adults. In this report, we present a case of jejunal hematoma that occurred following a minor abdominal trauma. The incidence of jejunal hematoma as a result of trauma is exceedingly uncommon.

Case presentation: We present a case of 48-year-male with history of abdominal trauma one year back presented with features of intestinal obstruction. Abdominal CT scan revealed intestinal obstruction at the level of the jejunum and was planned for surgery. During exploratory laparotomy, blood was seen in the peritoneum with the hemorrhagic mass at the jejunum. Resected specimen was sent for histopathology which showed hematoma involving submucosa, muscular, and peri-muscular fibrous tissue. Hence the diagnosis of jejunal hematoma was made.

Clinical discussion: Jejunal hematoma following trauma is a rare condition as compared to duodenal hematoma due to its relatively fixed position. Here in our case, abdominal trauma is the probable cause of jejunal hematoma. The symptoms range from mild abdominal pain to intestinal obstruction with acute abdomen. A coagulation profile should be done to rule out bleeding disorders which is one of the common causes of jejunal hematoma.

Conclusion: This rare case report guides healthcare professionals to include jejunal hematoma as a differential for a patient presenting with the symptoms of intestinal obstruction.