A Case of Secondary Rectal Intramural Hematoma Triggered by Aspiration for Endoscopic Mucosal Resection

Total colonoscopy was performed on an 89-year-old man who was not treated with anticoagulation therapy. He had developed purpura in the rectum below the peritoneal reflection by the aspiration for endoscopic mucosal resection to rectal polyp. The purpura resulted in spontaneous cessation, but he had lower abdominal pain thereafter. He was diagnosed to have intramural hematoma of the rectum from rectosigmoid to above the peritoneal reflection by computed tomography and sigmoidoscopy. It disappeared with conservative therapy. We infer that it was secondary rectal intramural hematoma triggered by excessive straining against purpura.