A case of spontaneous mesenteric hematoma in a hemodialysis patient

Abstract

We report a case of spontaneous mesenteric hematoma in a hemodialysis patient.
A 40-year-old woman, who had been on hemodialysis since the age of 30, was admitted to the hospital because of the sudden onset of lower abdominal pain. Abdominal CT scan showd a low density area suggestive of hematoma in the mesenterium of the sigmoid colon. Three hours later, abdominal enhanced CT scan showd enlargement of the hematoma and extravasation of contrast material to the sigmoid colon mesenterium. Angiography showed no extravasation of contrast material. But she showed advanced anemia, and then an emergency operation was performed. Laparotomy showed a massive hematoma in the sigmoid colon mesenterium, and sigmoidectomy including the hematoma was performed. Histopathological examination showed no vascular lesions. Therefore spontaneous mesenteric hematoma was definitely diagnosed. She was discharged from the hospital on the 28th day after the surgery. No recurrence has been seen.
Spontaneous mesenteric hematoma is so rare that only 44 cases, including our case, have been reported in the Japanese literature. This case is presented here, together with some bibliographical comments.