A Case of Omental Hemorrhage Treated by Laparoscopic Partial Omentectomy

Abstract

A 67–year–old female patient who was involved in a traffic accident was transported immediately to our hospital complaining of right upper abdominal pain. She had bruises and pain in her upper abdomen, and an abdominal contrast–enhanced CT showed high–density ascites and a mass with extravasation of the contrast agent within the mass. We suspected omental hemorrhage and performed angiography, which showed hemorrhage from a small branch of the right gastroepiploic artery. As transcatheter approach to the bleeding point is difficult due to the tortuosity of blood vessels, we performed laparoscopic partial omentectomy for hemostasis. Omental hemorrhage alone is a rare cause of intraabdominal hemorrhage in cases of blunt abdominal injury. Transcatheter arterial embolization for omental hemorrhage is minimally invasive, but it is sometimes difficult to reach the bleeding point due to the tortuosity of blood vessels, or achieve secure hemostasis due to the rich network of omental blood vessels. Operation for omental hemorrhage is relatively easy in terms of the approach to the bleeding point and resection of the greater omentum; laparoscopic surgery is especially useful, because it is less invasive.