A Case of Intraabdominal Bleeding due to Laceration of a Gastro-colic Membrane due to a Practice Swing

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  • SHIMIZU Yoshio
    Department of Surgery, Tsukuba Gakuen Hospital Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Faculty of Medicine, Tsukuba University
  • GOHONGI Takeshi
    Department of Surgery, Tsukuba Gakuen Hospital
  • IIDA Hiroyuki
    Department of Surgery, Tsukuba Gakuen Hospital
  • GUNJI Naoto
    Department of Surgery, Tsukuba Gakuen Hospital
  • OHKOHCHI Nobuhiro
    Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Faculty of Medicine, Tsukuba University

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Other Title
  • バット素振り練習時の胃結腸間膜断裂による腹腔内出血の1例
  • 症例 バット素振り練習時の胃結腸間膜断裂による腹腔内出血の1例
  • ショウレイ バット スブリ レンシュウジ ノ イ ケッチョウ カンマクダンレツ ニ ヨル フクコウ ナイシュッケツ ノ 1レイ

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Abstract

We report a case of a 20-year-old man with idiopathic intraabdominal bleeding without mechanical contusion. The patient swung a baseball bat for practice for 30 minutes immediately after excessive eating for dinner. A sudden abdominal pain occurred about four hours after the practice swing. When he presented to our hospital, no shock findings were seen but there were muscle guarding and rebound tenderness in the entire abdomen. Abdominal CT scan with contrast media revealed fluid retention suggestive of intraabdominal bleeding around the liver surface, Douglas fossa, left side of caeca without signs of bowel perforation. Emergent angiographic examination aiming at detection and embolization of ruptured artery was unable to demonstrate extravasation of contrast media in the celiac and superior mesenteric arteries. Thereafter he was found to be in a pre-shock state and was emergently operated on. At laparotomy, a gastro-colic menbrane was found torn by approximately 10 cm near the splenic flexure, where was inferred to be bleeding source, and the torn menbrane was resected. Resected specimen showed no structural abnormalities of vessels by pathological examination. The bleeding seemed to be due to the laceration of the gastro-colic membrane between the overloaded stomach and the transverse colon probably induced by quick and repeated twisting of the body trunk.

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