The authors report a case of intra-mural hematoma of the sigmoid associated with anticoagulant therapy. The small intestine is the site of predilection for intra-mural hematoma and the colonic site is very unusual. Our case was revealed by an obstructive syndrome. The diagnosis, suggested by the increased prothrombin time, was confirmed by ultrasonography and endoscopy. The treatment was symptomatic with nasogastric suction and correction of any hemostatic disorders.