A CASE OF IDIOPATHIC OMENTAL HEMORRHAGE

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A 30-year-old man admitted for upper abdominal pain with a diagnosis of acute abdomen underwent conservative therapy because peritoneal signs were poor and computed tomography (CT) of the abdomen showed no massive peritoneal effusion on admission. The next day, since anemia worsened and ascites increased rapidly in CT, abdominal hemorrhage was suspected, necessitating emergency surgery. On laparotomy, the abdomen was found to be filled with clotted and unclotted blood. After blood was removed, several omental portions were seen to be lacerated and hematoma formed at one near the greater curvature of the middle body of stomach. Partial omentectomy was done. Postoperative histopathological examination of the resected specimen showed hemorrhage without venous thrombosis or infarction. Based on pathological findings and the absence of a history of trauma, spontaneous omental hemorrhage was diagnosed. The postoperative course was uneventful.Omental hemorrhage is rare and, in most cases, is only diagnosed at laparotomy. This disease should be listed in the differential diagnosis for peritoneal hemorrhage without abnormal findings in peritoneal organs or mesenteries.
日本臨床外科学会の論文