A Case of Pseudoaneurysm of the Middle Colic Artery due to Abdominal Blunt Trauma

Abstract

An 85-year-old man accidentally struck a pole in the road while driving a car. He was taken to another hospital by ambulance, where contrast-enhanced computed tomography showed a large hematoma around the head of the pancreas, with rupture and pseudoaneurysm of the middle colic artery, and the patient was transferred to our hospital. Angiography showed bleeding from the distal dorsal pancreatic artery, and arterial embolization was performed. The middle colic artery was ruptured at its root, and since embolization was considered not feasible, emergency surgery was performed. Intraoperatively, although there was only a small amount of bloody ascites, a large hematoma extended from the area around the head of the pancreas head to the transverse mesocolon. The transverse mesocolon was partly damaged, and rupture and pseudoaneurysm were apparent at the root of the middle colic artery. Although there was no active bleeding, the arterial root was ligated to prevent recurrence. The patient's postoperative course was uneventful, with no recurrent hemorrhage, and he was transferred to another hospital for rehabilitation on postoperative Day 21. The occurrence of sudden deterioration due to pseudoaneurysm rupture caused by mesentery damage and cases of delayed onset have been reported, and if a hematoma is present within the mesentery, the possibility of pseudoaneurysm formation must be borne in mind during treatment.