Abstract
We present a report on preoperatively diagnosed omental hemorrhage-the first of its kind, insofar as we know. A 61-year-old man seen for widespread abdominal pain and distension in March 2007 was found to have slightly decreased hemoglobin hematological tests, and a small amount of ascites in abdominal ultrasonography (US) and computed tomography (CT). Imaging studies suggested hemoperitoneum. Abdominal CT angiography showed that contrast medium had clearly leaked from peripheral branches of the omental artery, yielding a diagnosis of omental hemorrhage caused by bleeding from the left omental artery. Two hours after, the man's vital signs became unstable and US indicated rapidly increasing ascites, necessitating emergency surgery. The hematoma in the left abdominal cavity and bleeding of the left omental artery were found intraoperatively and treated by partial omentectomy. Seventeen cases of idiopathic omental hemorrhage have been reported in Japan, 5 of which were diagnosed and 2 suspected preoperatively.
