PMC5928030_01
Computed tomography findings.. Computed tomography revealed a low-density mass close to the sigmoid colon, with a 10 cm diameter, and ascites accumulated around the spleen. Small extravasations were confirmed in the mass (arrows).
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Abdominal fluid was accumulated around the spleen and was still expanding (Fig. 1).
Interventional radiography findings.. Angiography from the inferior mesenteric artery revealed small extravasations in the region of the sigmoid colic arteries (arrows). The sigmoid colic arteries were embolized while preserving the left colic artery and superior rectal artery and the extravasations disappeared (b).
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Sigmoid arteriography revealed small active bleeding, and embolization was performed in the sigmoid arteries while preserving the left colic artery (LCA) and superior rectal artery (SRA) (Fig. 2).
Intraoperative findings and specimens.. During surgery, 200 mL of bloody ascites were found to be accumulated in the abdomen. The serosa of the sigmoid colon was ruptured without active bleeding (a). The hematoma was localized in the mesentery of the sigmoid colon and the anterior serosa was ruptured due to the compression of the hematoma (b, c).
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The bleeding from the ruptured serosa was halted (Fig. 3). The resected specimen indicated hematoma in the mesentery (Fig. 3b, c).