Skip to main content
Log in

Rupture of a huge infectious abdominal chronic expanding hematoma

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

A 72-year-old woman was referred to our hospital with the diagnosis of peritonitis due to the rupture of a huge abdominal cystic tumor, 27 cm in diameter. Abdominal computed tomography 14 years before revealed the tumor, which was 18 cm in diameter. She had undergone no examinations or treatment in the interim. She was in shock upon presentation to our hospital. She was intubated immediately and underwent an emergent laparotomy. The huge ruptured tumor with adherent small intestine was resected. The tumor weighed 6 kg and consisted of solid and cystic components filled with 4 kg of brown feces-like fluid. Bacteroides fragilis was detected in a fluid specimen. The cystic component of the tumor was filled with old blood clots, and a portion of the tumor wall was highly calcified. Old blood and fibrin with blood vessels of various sizes inside the tumor were observed during the pathologic evaluation; there were no malignant features. The final pathologic diagnosis was a chronic expanding hematoma (CEH). The patient had an uneventful recovery and was discharged 16 days post-operatively. She was involved in a traffic accident approximately 30 years before the current hospital admission; however, she did not recall if she had abdominal pain at that time. A CEH is a benign lesion, but rupture of a CEH can be life-threatening.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Reid JD, Kommareddi S, Lankerani M, et al. Chronic expanding hematomas. A clinicopathologic entity. JAMA. 1980;244:2441–2.

    Article  CAS  Google Scholar 

  2. Sakamoto A, Okamoto T, Matsuda S. Chronic expanding hematoma in the extremities: a clinical problem of adhesion to the surrounding tissues. Biomed Res Int. 2017;2017:4634350.

    Article  Google Scholar 

  3. Yaguchi D, Ichikawa M, Kimura H, et al. Sudden death due to recent hemorrhage from an intrathoracic chronic expanding hematoma. J Forensic Sci. 2019;64:625–8.

    Article  Google Scholar 

  4. Syuto T, Hatori M, Masashi N, et al. Chronic expanding hematoma in the retroperitoneal space: a case report. BMC Urol. 2013;13:60.

    Article  Google Scholar 

  5. Okubo K, Okamoto T, Isobe J, et al. Rupture of a chronic expanding hematoma of the thorax into lung parenchyma. J Thorac Cardiovasc Surg. 2004;127:1838–40.

    Article  Google Scholar 

  6. Endo S, Hasegawa T, Sato Y, et al. Thoraco-pleuropneumonectomy for rupture of a huge chronic hematoma of the thorax. Jpn J Thorac Cardiovasc Surg. 2005;53(3):162–4.

    Article  Google Scholar 

  7. Morioka D, Ohkubo F, Umezawa K. Chronic expanding hematoma, ruptured through the skin 53 years after buttock contusion. Int J Surg Case Rep. 2014;5:342–4.

    Article  Google Scholar 

  8. Brook I. Microbiology and management of abdominal infections. Dig Dis Sci. 2008;53:2585–91.

    Article  Google Scholar 

  9. Burgert-Lon CE, Riddle ND, Lackman RD, Evenski AJ, Brooks JS. Angiosarcoma arising in chronic expanding hematoma: five cases of an underrecognized association. Am J Surg Pathol. 2015;39:1540–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Toshiro Masuda.

Ethics declarations

Conflict of interest

Toshiro Masuda, Kazuto Harada, Kenji Shimizu, Ryuichi Karashima, Hidetoshi Nitta, Katsutaka Matsumoto, Tetsuya Okino, Takihiro Kamio, Hideo Baba and Hiroshi Takamori declare that they have no conflict of interest.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from the patient for being included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Masuda, T., Harada, K., Shimizu, K. et al. Rupture of a huge infectious abdominal chronic expanding hematoma. Clin J Gastroenterol 14, 782–786 (2021). https://doi.org/10.1007/s12328-021-01366-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-021-01366-x

Keywords

Navigation