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Open Access Case report

Spontaneous mesenteric hematoma complicating an exacerbation of Crohn’s disease: report of a case

Hutan Ashrafian12*, James HR Manfield1, Anuja Mitra1, Derek J Boyle1 and Pawan Mathur1

Author Affiliations

1 Department of General Surgery, Barnet Hospital, Barnet and Chase Farm Hospitals NHS Trust, Wellhouse Lane, Barnet EN5 3DJ, UK

2 Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM Building, St Mary’s Hospital, Praed Street, London W2 1NY, UK

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BMC Surgery 2014, 14:35  doi:10.1186/1471-2482-14-35

Published: 3 June 2014

Abstract

Case Presentation

Spontaneous mesenteric haematoma is a rare condition that occurs due to localized bleeding in the mesenteric vascular tree of a bowel segment in the absence of an identifiable cause. Here we report a case of spontaneous mesenteric haematoma during an inflammatory exacerbation of Crohn’s disease. The patient underwent surgical management for small bowel obstruction secondary to Crohn’s disease, however the concurrent presence of a spontaneous mesenteric haematoma in the mid-jejunal mesentery was successfully managed conservatively.

Conclusion

This case identifies the first association of spontaneous mesenteric haematoma with an exacerbation of Crohn’s disease and highlights the need to consider rare differential diagnoses such as SMH when performing radiological assessment of unexplained symptoms in inflammatory bowel disease patients.

Keywords:
Crohn’s disease; Mesenteric haematoma; Inflammatory bowel disease; Surgery