Giant rectal intramural hematoma following endoscopic submucosal dissection successfully treated with conservative therapy: A case report

Table 1 Dynamic clinical parameters and symptom progression during conservative management

Postoperative day	Main symptoms	Blood pressure (mmHg)	WBC (× 109/L; reference range: 3.50-9.50)	Hemoglobin (g/L; reference range: 130-175)	Urea (mmol/L; reference range: 3.6-9.5)	Creatinine (μmol/L; reference range: 57-111)	Liver function tests
Day 4	Hematochezia	102/58	14.02	121	9.0	137	Normal
Day 5	Abdominal distension and constipation	108/65	9.81	98	8.9	121	Normal
Day 6	No significant improvement	110/74	6.46	88	8.6	85	-
Day 7	Abdominal distension relieved	105/76	5.77	86	-	-	-
Day 8	No abdominal distension or constipation	115/80	5.5	92	6.9	68	Normal
Day 11	Recovering well	109/67	5.8	112	-	-	-
Day 15	Tolerating liquid diet well	112/78	5.96	115	3.6	63	Normal

“-” unmeasured data at that time point. WBC: White blood cell.

Table 2 Reported cases of intramural hematoma following gastrointestinal endoscopic procedures

Ref.	Complication	Year	Age (years)	Sex	Anticoagulant therapy	Lesion size (mm)	Device	Time to hematoma onset	Treatment	Outcome
[2]	Hematoma	2023	82	Male	Yes	25	ESD	Postoperative day 4	Conservative treatments	Died on postoperative day 25
[6]	Hematoma	2022	50	Female	No	No available	Colonoscopy	Three hours	Surgery	Discharged
[7]	Hematoma	2023	81	Female	Yes	7	Cold snare polypectomy	Following day	Conservative treatments	Discharged 20 days after admission
[9]	Hematoma	2022	61	Female	No	8	Cold snare polypectomy	Following day	Endoscopic intervention	Hematoma absorption 3 days after intervention
[10]	Hematoma + perforation	2025	43	Female	No	3	Cold snare polypectomy	Two hours	Surgery	Discharged on postoperative day 14

ESD: Endoscopic submucosal dissection.