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<p>Intramural cecal hematoma is an exceptionally rare entity in children and may mimic acute appendicitis because of nonspecific clinical findings. We report a 12-year-old girl who presented with right lower quadrant pain following blunt abdominal trauma and was found to have a large intramural hematoma arising from the posterior wall of the cecum. The diagnosis was established using ultrasonography and cross-sectional imaging, which demonstrated marked luminal indentation without signs of perforation or active bleeding. Despite the considerable size of the lesion and an initial decrease in hemoglobin level, the patient remained hemodynamically stable and was successfully managed conservatively with close clinical and radiologic follow-up. Serial imaging showed progressive regression of the hematoma, and surgical intervention was avoided. This case highlights the importance of considering intramural cecal hematoma in the differential diagnosis of acute right lower quadrant pain in children and emphasizes that, in carefully selected patients without obstruction or ongoing hemorrhage, nonoperative management can be a safe and effective treatment option.</p>

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Conservative Management of a Giant Intramural Cecal Hematoma Following Blunt Abdominal Trauma in a Child: A Rare Case Report

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Neslihan Gulcin,
  • Ceyhan Sahin

摘要

Intramural cecal hematoma is an exceptionally rare entity in children and may mimic acute appendicitis because of nonspecific clinical findings. We report a 12-year-old girl who presented with right lower quadrant pain following blunt abdominal trauma and was found to have a large intramural hematoma arising from the posterior wall of the cecum. The diagnosis was established using ultrasonography and cross-sectional imaging, which demonstrated marked luminal indentation without signs of perforation or active bleeding. Despite the considerable size of the lesion and an initial decrease in hemoglobin level, the patient remained hemodynamically stable and was successfully managed conservatively with close clinical and radiologic follow-up. Serial imaging showed progressive regression of the hematoma, and surgical intervention was avoided. This case highlights the importance of considering intramural cecal hematoma in the differential diagnosis of acute right lower quadrant pain in children and emphasizes that, in carefully selected patients without obstruction or ongoing hemorrhage, nonoperative management can be a safe and effective treatment option.