Blocked by a clot: subserosal cecal hematoma causing bowel obstruction – a case report

Introduction and importance: Bowel wall hematoma is rare and most commonly involves the submucosal or intramural layers. An isolated subserosal hematoma is particularly uncommon and may mimic malignant or inflammatory pathology on imaging, creating diagnostic and management challenges. Presentation of case: We report the case of a young man presenting with right iliac fossa pain and features of bowel obstruction, who was found to have a large cecal subserosal hematoma requiring a right hemicolectomy. Clinical discussion: This case highlights the importance of considering bowel wall hematoma in the differential diagnosis of obstructing colonic lesions, particularly in patients with a history of abdominal trauma, and adds to the limited literature describing subserosal involvement. Conclusion: Early recognition and appropriate management are essential to ensure favorable outcomes. While operative and nonoperative management may yield good outcomes, we observed a positive outcome for our young patient with operative management.