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ID 57590
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Nakamura, Shunsuke Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
Yamada, Taihei Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Kaken ID researchmap
Nojima, Tsuyoshi Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Naitou, Hiromichi Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Kaken ID
Koga, Hitoshi Department of Emergency Medicine, St. Mary’s Hospital
Yamashita, Hisashi Department of Emergency Medicine, St. Mary’s Hospital
Gochi, Akira Department of Surgery, Ibara City Hospital
Nakao, Atsunori Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Kaken ID
Abstract
Introduction: Spontaneous mesenteric hematoma is an uncommon syndrome triggered by bleeding localized in the mesenteric vascular tree of a bowel segment for no apparent underlying reason. We herein report a surgical patient with an extremely rapidly growing spontaneous mesenteric hematoma that we successfully diagnosed using careful radiologic examination.
Presentation of case: A 56-year-old old male presenting sudden onset lower abdominal pain was referred to our emergency department. At the time of admission, his physical examination revealed stable vital signs without radiological abnormality. On the following day, the patient suddenly presented hypotension, tachycardia, and increased abdominal pain. Contrast-enhanced computed tomography examination showed a mass with both high- and low-density areas with a 130 mm maximum diameter bordering the transverse colon. Since interventional radiologists were not available, we decided to perform emergency exploratory laparotomy. On laparotomy, a 13 × 8 cm hematoma was found in the mesentery of the transverse colon. As bleeding was noted from the branches of the middle colic artery and gastrocolic artery, these responsible vessels were ligated. The patient was finally given the diagnosis of spontaneous mesenteric hematoma.
Discussion and conclusion: The present case, initially diagnosed as enterocolitis, suddenly manifested hypovolemic shock. Close monitoring for any signs of further deterioration, as well as aggressive imaging diagnosis, enabled us to avoid delays in treatment. Early diagnosis and treatment of mesenteric hematomas are essential to prevent them from rupturing and triggering life-threatening adverse events.
Keywords
Acute care surgery
Computed tomography
Mesenteric hematoma
Published Date
2019-12-31
Publication Title
International Journal of Surgery Case Reports
Volume
volume65
Publisher
Elsevier
Start Page
124
End Page
126
ISSN
22102612
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2019 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
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isVersionOf https://doi.org/10.1016/j.ijscr.2019.10.058
License
http://creativecommons.org/licenses/by/4.0/
Citation
Nakamura S, Yamada T, Nojima T, et al. A case of spontaneous mesenteric hematoma successfully diagnosed and treated with aggressive imaging. Int J Surg Case Rep. 2019;65:124‐126. doi:10.1016/j.ijscr.2019.10.058
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OA
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