title: Report of a case with a spontaneous mesenteric hematoma that ruptured into the small intestine.
abstract: BACKGROUND
  A spontaneous mesenteric hematoma is a rare condition. Furthermore, it is extremely rare that the mesenteric hematoma caused gastrointestinal bleeding with an unknown etiology. We experienced a case with a spontaneous mesenteric hematoma that ruptured into the jejunum.
  
  
  METHODS
  A 75-year-old man was referred to our hospital because of anal bleeding and anemia. Abdominal computed tomography (CT) showed a low density mass measuring 3.0cm in diameter, including an enhanced spot. This finding suggested that a pseudo-aneurysm or mesenteric hematoma caused active bleeding into the jejunum. He underwent emergent laparotomy and partial resection of the jejunum and the mesentery including the tumor. A histological examination of the jejunum indicated no pathogenic findings causing active bleeding. And there were no findings suggesting the mesenteric aneurysm had developed. The patient had no history related to the development of a mesenteric hematoma, such as trauma, labor, surgery, or anticoagulant treatment. Therefore, we finally diagnosed that a spontaneous mesenteric hematoma had ruptured into the jejunum.
  
  
  CONCLUSIONS
  We reported extremely rare condition that the mesenteric hematoma was developed and ruptured into the jejunum without definitive etiology.
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shikata
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan. Electronic address: h-nakagomi@ych.pref.yamanashi.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakagomi
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takano
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakagomi
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maruyama
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Nakada
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Furuya
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Hada
authors.affiliation: Department of Surgery, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Miyasaka
authors.affiliation: Internal Medicine, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.affiliation: Pathology, Yamanashi Prefectural Central Hospital, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Oyama
keywords: Anal bleeding; Etiology; Ruptured into the jejunum; Spontaneous mesenteric hematoma