Large intramural colonic hematoma after polypectomy

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A 77-year-old man, who had undergone surgery 1 year previously for a colorectal carcinoma of the sigmoid colon, came to our endoscopy unit for surveillance colonoscopy. A 10-mm, pedunculated, polyp was observed at 45 cm from the anus. The patient was not receiving anticoagulation or antiaggregation treatment, and his platelet count and prothrombin activity were normal.

The lesion was resected using a snare and endocut (ERBE ICC 200). A few seconds later, a progressively bulging congestive mass, corresponding to a large intramural colonic hematoma, appeared below the polypectomy site and occupied almost all the colonic lumen ([Fig. 1] and [2]).

Fig. 1 Intramural colonic hematoma.

Fig. 2 Polypectomy site with bulging mass in the upper margin.

The patient was admitted for observation and showed no important decrease in hematocrit level or any symptom. At 4 days after the event, a surveillance colonoscopy showed violet-colored flat mucosa, without the mass previously seen ([Fig. 3]).

Fig. 3 Appearance at 4 days after the polypectomy.

Endoscopy_UCTN_Code_CPL_1AJ_2AC