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A rare diagnosis of abdominal pain presentation in the emergency department: Idiopathic omental bleeding: A case report.

Abstract Idiopathic omental bleeding is a rare cause of acute abdomen, with only a few reported cases. It usually presents with abdominal pain and may be life-threatening. As it rarely occurs, it may not be considered initially during patient presentation.
PMID
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Authors

Mayor MeshTerms

Omentum

Keywords
Journal Title medicine
Publication Year Start




PMID- 29390583
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - A rare diagnosis of abdominal pain presentation in the emergency department:
      Idiopathic omental bleeding: A case report.
PG  - e9463
LID - 10.1097/MD.0000000000009463 [doi]
AB  - RATIONALE: Idiopathic omental bleeding is a rare cause of acute abdomen, with
      only a few reported cases. It usually presents with abdominal pain and may be
      life-threatening. As it rarely occurs, it may not be considered initially during 
      patient presentation. PATIENT CONCERNS: A 35-year-old male came to our emergency 
      department with abdominal pain present for around 5 to 6 hours. The patient
      complained of left upper quadrant abdominal pain after eating breakfast. The only
      associated symptom was 3 episodes of vomiting up food. Physical examination
      revealed mild left upper quadrant abdominal tenderness without muscle guarding or
      rebounding pain. Blood examination showed leukocytosis with neutrophil
      predominance and C reactive protein elevation. The pain was persistent and relief
      was not obtained by medication. DIAGNOSES: Computed tomography showed a large
      lobular-contour homogenous slightly hyperdense lesion without enhancement along
      the greater curvature of the stomach in the lesser sac. A surgeon was consulted
      and laparotomy was suggested. Hematoma was found at Morrison pouch, subsplenic
      fossa, and lesser sac under operation. INTERVENTION: Laparotomy and ligation for 
      hemostasis. OUTCOMES: The patient was discharged with stable condition after 7
      days of hospitalization. LESSONS: This diagnosis should be considered in patients
      presenting with epigastric pain and vomiting after eating while in the emergency 
      department because this disease might be life-threatening. This case highlights 2
      important learning points. First, idiopathic omental bleeding could occur after
      eating in patients without underlying disease or trauma history, and this disease
      should be taken into consideration when acute abdomen occurs. Second, emergent
      laparotomy is indicated if the cause of acute abdomen is not clear.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Wu, Yen-Hung
AU  - Wu YH
AD  - Department of Emergency Medicine, Kaohsiung Medical University Hospital.
FAU - Liu, Kuan-Ting
AU  - Liu KT
AD  - Department of Emergency Medicine, Kaohsiung Medical University Hospital.
AD  - School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,
      Taiwan.
FAU - Wen, Chun-Kai
AU  - Wen CK
AD  - Department of Emergency Medicine, Kaohsiung Medical University Hospital.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Abdominal Pain/diagnostic imaging/*etiology
MH  - Adult
MH  - Emergency Service, Hospital
MH  - Hemorrhage/complications/*diagnosis/diagnostic imaging/surgery
MH  - Humans
MH  - Male
MH  - *Omentum/diagnostic imaging/surgery
MH  - Peritoneal Diseases/complications/*diagnosis/surgery
MH  - Tomography, X-Ray Computed
PMC - PMC5758285
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009463 [doi]
AID - 00005792-201712220-00170 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e9463. doi: 10.1097/MD.0000000000009463.