A Case with a Diagnosis of Omental Hemorrhage before Surgery

Katsumi Makita, Takemasa Midorikawa, Hidefumi Yagi, Yasuro Fujiwara, Kunitoshi Aita, Michio Sakamoto, Terukazu Yokoyama¹⁾ and Masahiko Ookubo²⁾

Department of Surgery and Department of Radiology¹⁾, Showa Hospital, Tomogikukai Medical Corporation
Ookubo Hospital²⁾

We present a report on preoperatively diagnosed omental hemorrhage-the first of its kind, insofar as we know. A 61-year-old man seen for widespread abdominal pain and distension in March 2007 was found to have slightly decreased hemoglobin hematological tests, and a small amount of ascites in abdominal ultrasonography (US) and computed tomography (CT). Imaging studies suggested hemoperitoneum. Abdominal CT angiography showed that contrast medium had clearly leaked from peripheral branches of the omental artery, yielding a diagnosis of omental hemorrhage caused by bleeding from the left omental artery. Two hours after, the man's vital signs became unstable and US indicated rapidly increasing ascites, necessitating emergency surgery. The hematoma in the left abdominal cavity and bleeding of the left omental artery were found intraoperatively and treated by partial omentectomy. Seventeen cases of idiopathic omental hemorrhage have been reported in Japan, 5 of which were diagnosed and 2 suspected preoperatively.

Key words
omental hemorrhage, Idiopathic, CT angiography

Reprint requests
Takemasa Midorikawa Department of Surgery, Showa Hospital, Tomogikukai Medical Corporation
911-1 Tokunaga, Nishi-ku, Fukuoka, 819-0375 JAPAN

Accepted
January 28, 2009

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