A case of spontaneous mesenteric hematoma

Abstract

A 60-year-old male with no significant past medical history or trauma visited our outpatient unit for repeated episodes of abdominal pain and distension, persisting over several years, in August 2007. There were no abnormal findings on physical or laboratory examinations. Ultrasonography and abdominal computed tomography (CT) revealed a well defined, heterogeneous cystic lesion measuring 53mm in diameter. Follow-up abdominal CT at two months showed that the cystic lesion had decreased in size. Differential diagnoses of the cystic lesion included mesenteric lymphangioma, alimentary tract duplication cyst, and gastrointestinal stromal tumor. Initial laparoscopic exploration demonstrated immobility of the cystic mass which was located at the root of the mesentery. Open resection of the mass was therefore performed. There were no postoperative complications and the patient was discharged on the fifth postoperative day. Microscopic examination showed no signs of malignancy and the cystic mass was diagnosed as a mesenteric hematoma. We describe herein a case of spontaneous mesenteric hematoma and discuss its clinical features, diagnosis and management.