Abstract
We report a case of cystic medial necrosis with intra-abdominal bleeding due to rupture of the sigmoidal artery. Cystic medial necrosis often occurs in the great arteries and rarely involves the peripheral arteries in the abdominal cavity.
A 64-year-old woman was admitted because of sudden lower abdominal pain. Abdominal CT scan showed a hematoma about 9 cm in diameter in the mesentery of the sigmoid colon. She was diagnosed as being in shock due to intra-abdominal bleeding caused by rupture of the sigmoidal artery ; an emergency laparotomy was performed. On laparotomy, the bleeding site involving the sigmoidal artery was found, and the sigmoid colon including the mesentery was resected. On pathology cystic medial necrosis was diagnosed. The patient has since been free from recurrences.
