Abstract
We report a case of idiopathic mesenteric hematoma, and review reported cases in the Japanese literature.A 55-year-old man woke up one day with pain throughout his abdomen, and visited the emergencydepartment of our hospital early on the following day. On examination, his entire abdomen appeared to beseverely painful and showed a board-like rigidity. A CT scan of the abdomen revealed intraperitoneal fluidretention, and a mass extending from the retroperitonium to the mesentery. He was admitted under thediagnosis of acute abdomen for further check-up and treatments. After admission, he showed advancedanemia. Ultrasound-guided needle aspiration yielded bloody ascites, and an emergency surgery was subsequentlyperformed. A large amount of bloody ascites was identified in the peritoneal cavity, and hematomaswere seen around the descending portion through the transverse portion of the duodenum, around theperiphery of the superior mesenteric artery, and in the mesentery. No bleeding point could be determined.The patient did not have any history of trauma, and furthermore, neither angiography nor surgery determinedthe source of the bleeding. If there intraperitoneal bleeding of unknown cause is seen in a patient, the presence of idiopathic mesenteric hematoma should be considered as a possible cause, although it is rare.
