Intramural Hematomas in Gastrointestinal Systems
Summary
Intramural haematomas of the gastrointestinal tract represent a focal collection of blood within the wall of an organ, most commonly affecting the oesophagus, duodenum, small intestine, colon and, more rarely, the stomach. They arise through direct trauma, anticoagulant or antithrombotic therapy, bleeding diatheses and, on occasion, local inflammatory processes such as pancreatitis. Clinically, presentations range from acute abdominal pain, nausea and gastrointestinal bleeding to obstruction or perforation in severe cases. Cross-sectional imaging modalities, notably computed tomography and magnetic resonance imaging, are pivotal for early diagnosis and differentiation from neoplastic or inflammatory masses. Endoscopic evaluation may complement these techniques, providing both visual assessment and therapeutic options. Management strategies are determined by haemodynamic stability, extent of obstruction and underlying aetiology, with conservative approaches—comprising cessation or reversal of anticoagulation, bowel rest and parenteral support—employed in the majority of cases. Surgical or endovascular interventions, such as selective angioembolisation or resection, are reserved for uncontrolled bleeding, ischaemia or perforation. Awareness of this condition is of growing importance given the global rise in anticoagulant use and the ageing population, demanding multidisciplinary protocols to optimise outcomes and minimise misdiagnosis.
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Intramural Hematomas in Gastrointestinal Systems publication trend
The graph below shows the total number of articles in intramural hematomas in gastrointestinal systems across all publications each year (not limited to Nature Index journals).
Technical terms
Intramural haematoma: A localized accumulation of blood within the wall layers of a gastrointestinal organ.
Coagulopathy: A disorder in which the blood’s ability to clot is impaired.
Anticoagulation therapy: Medical treatment that reduces blood-clot formation, commonly with heparins or vitamin-K antagonists.
Computed tomography (CT): A radiological technique producing cross-sectional images of the body using X-rays and computer reconstruction.
Angioembolisation: A minimally invasive procedure in which bleeding vessels are occluded using endovascular agents to control haemorrhage.
References
- Spontaneous isolated gastric intramural hematoma combined with spontaneous superior mesenteric artery intermural hematoma: a rare case. BMC Geriatrics (2024).
- Case Report: Spontaneous Intramural Hematoma of the Colon Secondary to Low Molecular Weight Heparin Therapy. Frontiers in Pharmacology (2021).
- Intramural duodenal hematoma: clinical course and imaging findings. Acta Radiologica Open (2019).
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