Spontaneous mesenteric hematoma of the sigmoid colon associated with rivaroxaban: A case report

International Journal of Surgery Case Reports
Katsuhisa HiranoTsutomu Fujii

Abstract

Mesenteric hematoma is a rare condition caused by bleeding localized in the mesenteric vascular tree. This is a first report of spontaneous mesenteric hematoma caused by rivaroxaban. The patient was a 71-year-old man who had taken rivaroxaban for paroxysmal atrial fibrillation. He had experienced abdominal pain and diarrhea for the prior 3 days. He had little melena and was referred to our institute. He presented with hypotension on arrival. Computed tomography (CT) revealed a 10 cm mass in the mesentery of the sigmoid colon with extravasation. Active bleeding from the sigmoid colic arteries was embolized with angiography on the day of admission. On the second day, we operated on the patient. We detected 200 mL of bloody ascites accumulated in the abdomen. The serosa of the sigmoid colon was ruptured along the tenia due to the compression of the hematoma in the mesentery. The sigmoid colon was resected and a descending colostomy was reconstructed. Operative and pathological findings did not reveal the cause of bleeding. We finally diagnosed the patient with spontaneous mesenteric hematoma associated with rivaroxaban. Previous reports of mesenteric hematoma with anticoagulant were associated with warfarin. Since rivaroxaban is n...Continue Reading

Citations

Jun 4, 2020·Surgical Case Reports·Nobuhisa TaniokaKazuhiro Hanazaki
Jan 13, 2021·ANZ Journal of Surgery·Masayuki UrabeMasaki Ueno
Jul 27, 2021·Clinics in Colon and Rectal Surgery·Allison A AkaTeresa DeBeche-Adams
Aug 15, 2021·BMJ Case Reports·May Honey OhnKhin Maung Ohn

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