PMC3162978_01
Preoperative computed tomography scan of the abdomen showing extensive hemoperitoneum (a) below the spleen and liver, among the small bowel, (b) in the left and right paracolic gutter, in front of the urinary bladder with a distended rectum.
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fig1
Surgical view shows an edematous rectal wall with hemorrhagic infiltration of the upper and medial rectal third. A seromuscular tear in the anterior tenia of the rectum is evident, together with an intact, bulging mucosa.
CRIM2011-313841.002.jpg
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fig2
The subsequent intramural hematoma extended along the middle and upper rectal third, determining a 7 cm long seromuscular tear in the anterior tenia (Figure 2), responsible for the massive intra-abdominal bleeding.