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Journal of Trauma and Injury 2013;26(4):300-303.
Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor: A Case Report
Jong Min Park, Seong Yup Kim, Il Yong Chung, Woo Shik Kim, Yong Chul Shin, Yeong Cheol Kim, Sei Hyeog Park
Department of Trauma Surgery, National Medical Center, Seoul, Korea. surgery2002@medimail.co.kr
복강내 종양으로 오인된 외상성 혈종: 증례보고
박종민, 김성엽, 정일용, 김우식, 신용철, 김영철, 박세혁
국립중앙의료원 외상외과
Received: 29 October 2013   • Revised: 19 December 2013   • Accepted: 19 December 2013
Abstract
Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.
Key Words: Abdominal injuries; Mesentery; Hematoma; Neoplasms


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