特発性上行結腸間膜血腫の１例

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  • A CASE OF A SPONTANEOUS MESENTERIC HEMATOMA OF THE ASCENDING COLON

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A 25-year-old man was admitted to the hospital because of abdominal pain in the right lower quadrant lasting for a week. Abdominal computed tomographic scan demonstrated a mass of low density adjacent to the ascending colon, only the marginal area of which was slightly enhanced with contrast medium. The operation was carried out with a preoperative diagnosis of intra-abdominal abscess due to appendicitis or colon diverticulitis. A hematoma, 5×4×4cm in size, was found in the mesentery of the ascending colon. The bleeding point could not be determined and re-bleeding was probable, so that ileocecal resection, including the hematoma, was performed. Histopathological examination showed hematoma surrounded by collagenous granulation tissue, and no tumor or vascular lesion was detected. The patient had no history of trauma, anticoagulant therapy or vascular disease. Therefore spontaneous mesenteric hematoma was definitely diagnosed. The patient could have been treated conservatively or have only needed removal of the hematoma, if we had preoperatively diagnosed the tumor as mesenteric hematoma and had denied the presence of ruptured arterial aneurysm with angiography.

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