A Case of Omental Granuloma (Braun tumor) Accompanying Intraabdominal Bleeding

Shuichiro Uchiyama^1)-3), Yoshihisa Ando¹⁾, Koji Seguchi¹⁾, Kenji Toyonaga¹⁾, Shushi Higashi¹⁾, Hiroshi Itoh²⁾, Hiroaki Kataoka²⁾ and Kazuo Chijiiwa³⁾

Department of Surgery, Miyakonojo Medical Association Hospital¹⁾
Second Department of Pathology²⁾ and Department of Surgery 1³⁾
Faculty of Medicine, University of Miyazaki

Omental granuloma, also called a Braun tumor, rarely causes intraabdominal bleeding. A 58-year-old man transfered by ambulance due to severe epigastralgia with muscular defense was found in physiological examination to be in hemorrhagic shock. Abdominal computed tomography showed intraabdominal effusion and a mass in the gastric wall, strongly suggesting intraabdominal bleeding caused by intraabdominal rupture of the submucosal gastric tumor. Laparotomy confirmed the abdominal cavity to be filled with zanguinous effusion and a round mass adhering to the gastric wall and transverse colon and having a partically torn capsule. Because the mass could not be differentiated from malignancy, we conducted distal gastrectomy and partial resection of the transverse colon. Postoperative histopathology showed no apparent neoplastic component in the resected specimen but did show inflammatory granulation tissue. Because the patient had no history of abdominal surgery, the precise tumor cause remains unclear. This is, to our knowledge, only the second such report in Japan describing omental granuloma accompanying intraabdominal bleeding.

Key words
omental granuloma, intraabdominal bleeding, Braun tumor

Reprint requests
Shuichiro Uchiyama Department of Surgery 1, Miyazaki Medical College, Faculty of Medicine, University of Miyazaki
5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
November 30, 2004

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