Abstract
A 77-year-old man with a history of type 2 diabetes and pulmonary embolism who had undergone esophagectomy was brought to the emergency department with severe epigastric pain and imminent shock. Computed tomography showed abundant mesenteric air. We suspected peritonitis due to gastrointestinal (GI) tract perforation and performed emergency surgery. Operative findings showed no GI tract perforation, but obvious mesenteric emphysema and abscess were present. We diagnosed idiopathic mesenteric abscess. However, the literature indicates that mesenteric abscess is usually secondary to an intestinal perforation, diverticulitis, fish bone, Crohn's disease, or cancer. Idiopathic mesenteric abscess is rarely reported. In this case, we considered that impaired mesenteric blood flow and bacterial translocation due to diabetes type 2 and malnutrition after esophagectomy led to abscess formation.
