Report of a case with a spontaneous mesenteric hematoma that ruptured into the small intestine

Shikata, Daichi; Nakagomi, Hiroshi; Takano, Atsushi; Nakagomi, Takahiro; Watanabe, Hideki; Maruyama, Masahiro; Nakada, Haruka; Yamamoto, Atsushi; Furuya, Kazushige; Hada, Masao; Miyasaka, Yoshiaki; Omata, Masao; Oyama, Toshio

doi:10.1016/j.ijscr.2016.05.034

Cited by 17 publications

(16 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…La etiología de los hematomas mesentéricos, en su mayor frecuencia es por traumatismos; siendo su aparición espontánea algo infrecuente. Los de índole no traumática pueden vincularse a conectivopatías, neoplasias, arteriopatías, coagulopatías, terapia anticoagulante, pancreatitis aguda, enfermedad de Crohn y hernia inguinal encarcelada 2,6,7,8 . Actualmente no existen protocolos claros de tratamiento 2,8,9 .…”

Section: Discussionunclassified

Hematoma mesentérico espontáneo asociado a warfarina con resolución quirúrgica

Montero

Petersen

Cafaro

et al. 2019

Rev Fac Cien Med Univ Nac Cordoba

View full text Add to dashboard Cite

Introducción: El hematoma mesentérico espontaneo es poco frecuente. Se ha informado como complicación de anticoagulación prolongada, asociado con mayor frecuencia a la warfarina. El estudio diagnostico estándar es la tomografía computada. La terapéutica de esta patología, está en discusión. Se sabe que en pacientes hemodinámicamente estables con hematoma mesentérico espontaneo se lleva a cabo una conducta conservadora, dejando el tratamiento quirúrgico como alternativa para pacientes en shock. Nuestro objetivo es reportar el caso de una paciente adulta con hematoma mesentérico espontáneo en relación a warfarina, tratado de manera quirúrgica con buena evolución. Caso clínico: Paciente de 67 años, sexo femenino, con hematoma mesentérico espontáneo en relación a warfarina, con antecedente de reemplazo de válvula biológica mitral con plástica tricúspidea de más de 3 meses, en controles diarios por mal manejo de la coagulación con anticoagulante oral; consulto por dolor abdominal súbito, en región epigástrica, acompañado de vómitos gástricos. Al examen físico se objetivo defensa y reacción peritoneal. Se solicitó tomografía computada abdomen y pelvis donde se informó hematoma mesentérico. Debido a que la paciente presentaba signos de irritación peritoneal se realizó cirugía de urgencia con resección segmentaria de intestino delgado. Con buena evolución postquirúrgica, siendo dada de alta al quinto día. Anatomía patológica informa hemorragia masiva submucosa. Conclusión: Ante un paciente que presenta dolor abdominal con signos de irritación peritoneal, alteración de la Relación Internacional Normatizada por consumo de warfarina, sin historia traumática, debe sospecharse un hematoma mesentérico espontáneo y considerar el tratamiento quirúrgico.

show abstract

Section: Discussionunclassified

Hematoma mesentérico espontáneo asociado a warfarina con resolución quirúrgica

Montero

Petersen

Cafaro

et al. 2019

Rev Fac Cien Med Univ Nac Cordoba

View full text Add to dashboard Cite

show abstract

“…Spontaneous mesenteric hematoma is diagnosed if these clinical or pathological findings are not confirmed. Spontaneous mesenteric hematoma is potentially caused by anti-coagulation therapy, connective tissue diseases such as Ehlers-Danlos syndrome, and other diseases including Crohn’s disease and incarcerated inguinal hernia [ [2] , [3] ]. The responsible vessels are mostly the superior mesenteric arteries.…”

Section: Discussionmentioning

confidence: 99%

“…Non-traumatic mesenteric hematoma is associated with mesenteric vascular disease. Spontaneous mesenteric hematoma is diagnosed as a hematoma that does not satisfy these clinical or pathological features and is potentially associated with collagen diseases, anticoagulants, and other diseases such as Crohn’s disease [ [2] , [3] ].…”

Section: Introductionmentioning

confidence: 99%

Spontaneous mesenteric hematoma of the sigmoid colon associated with rivaroxaban: A case report

Hirano

Bando

Osawa

et al. 2018

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…1 Most patients suffering from SMH were over 50 years old of age, being consisted with the listed cases (12/20). 9 Anticoagulation treatments such as heparin and coumarin derivatives are occasionally seen in SMHs (5/20). On the other hand, patients with antiplatelet therapy were rare (2/20).…”

Section: Case Reportmentioning

confidence: 99%

“…5,7,[9][10][11] Here, we present a rare case of SMH in the sigmoid colon secondary to antiplatelet therapy.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous mesenteric hematoma after antiplatelet therapy: a case report

et al. 2018

View full text Add to dashboard Cite

Spontaneous mesenteric hematoma (SMH) is one of the rare conditions with abdominal mass secondary to hemorrhage. It develops due to regional bleeding in the mesenteric vessel of a gastrointestinal tract. The unusual morphology and lack of apparent etiology of SMH make it difficult to diagnose. A 57-year-old woman was referred to our hospital for intermittent abdominal pain with nausea and vomiting. She was receiving antiplatelet therapy by aspirin from idiopathic thrombocytosis. The number of platelet was above the normal level. CT showed a tumor-like lesion with arterial extravasation in the left lower abdomen. Mesenteric hematoma was considered since the mass was located between two branches of inferior sigmoid artery (IMA). Emergency laparotomy was performed and a mesenteric hematoma adjacent to the sigmoid colon was identified. The mesenteric hematoma was resected with the regional sigmoid colon. Pathology report showed intact mucous membrane of the excision without tumors or aneurysm. SMH was finally confirmed. The patient returned to her daily life without complaining of any symptoms. When a patient on antiplatelet therapy complained of acute abdominal pain, SMH has to be taken into consideration. Abdominopelvic CT scan is an effective investigation for diagnosis, and conservative therapy or emergent exploratory laparotomy could be an optional treatment. To the best of our research in Medline, there have only seven cases of colorectal SMH. Authors reportrd a rare case of SMH located at sigmoid colon, which appeared after antiplatelet therapy.

show abstract

Report of a case with a spontaneous mesenteric hematoma that ruptured into the small intestine

Abstract: HighlightsThis article reports an extremely rare case of spontaneous mesenteric hematoma that ruptured into the jejunum. The etiology of this condition was not revealed by detailed pathological examinations.

Cited by 17 publications

References 16 publications

Hematoma mesentérico espontáneo asociado a warfarina con resolución quirúrgica

Hematoma mesentérico espontáneo asociado a warfarina con resolución quirúrgica

Spontaneous mesenteric hematoma of the sigmoid colon associated with rivaroxaban: A case report

Spontaneous mesenteric hematoma after antiplatelet therapy: a case report

Contact Info

Product

Resources

About