Segmental arterial mediolysisが成因と考えられた小網出血の1例

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タイトル別名
  • A case of abdominal apoplexy due to hemorrhage from the lesser omentum
  • ショウレイ Segmental arterial mediolysis ガ セイイン ト カンガエラレタ ショウモウ シュッケツ ノ 1レイ

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The patient was a 57-year-old woman who developed sudden epigastric pain and was admitted to the emergency department. She had undergone an operation for uterine cancer 5 years ago. Computed tomography (CT) scan revealed ascites and a non enhanced shadow behind the stomach. Ascites aspiration revealed bloody ascitic fewid. A diagnosis of acute intra-abdominal bleeding was made, and urgent laparotomy was performed. The mesentery was ruptured at the gastric angle. Hemorrhage and clotting of blood were detected ; therefore, hemorrhage was diagnosed to occur from this point. Bleeding was stopped by partial resection of the mesenterium near the parts in which hemorrhage was observed. Pathological examination revealed no tumorous lesion. The patient showed no abdominal trauma or bleeding diathesis. She was diagnosed with segmental arterial mediolysis characterized by hemorrhage from the lesser omentum. Abdominal apoplexy due to hemorrhage from the lesser omentum is extremely rare. We report this case with review of the literature.

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