PMC10196634_01
(Case 1) (A): enhanced CT of the upper abdomen showing a mass in the greater curvature of the stomach (green arrows), with fluid/blood accumulation around the liver and spleen (red arrow); (B): the boundary between the hematoma and the greater curvature of the gastric wall was not clear (green arrow); (C): intraoperative resection of the hematoma and part of the wedge-shaped gastric wall (green arrows); (D): postoperative pathological examination identified identified an omental capillary hemangioma with hemorrhage (HE x 100).
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F1
Abdominal enhanced computed tomography (CT) revealed an effusion in the abdomen and pelvis, suspicious blood accumulation around the liver and spleen, and a slightly patchy high-density shadow on the side of the great curvature of the gastric body, about 9.8 x 6.9 x 6.5 cm in size (Figure 1A). During the procedure, about 1,400 ml of bloody fluid was found in the abdominal pelvic cavity, and an elliptical mass about 10.1 x 8.2 x 8.0 cm in size, with a surrounding blood clot was detected in the omentum of the greater curvature of the gastric body (Figure 1B). Therefore, the mass and the attached wedge-shaped stomach wall were simultaneously removed by an endoscopic linear cutting stapler (EC60A, Ethicon) (Figure 1C). Postoperative pathological examination revealed an omental capillary hemangioma with hemorrhage (Figure 1D), and the patient was discharged on postoperative Day 7.
PMC10196634_02
(Case 2) (A): CT-scan showing the formation of calcified plaques in the abdominal aorta (green arrow), bilateral common iliac artery, bilateral internal iliac artery, and right external iliac artery, partially accompanied by mural thrombosis; (B): enhanced CT of the upper abdomen showing hematoma formation in the upper left abdominal cavity, an unclear boundary between the hematoma and stomach (green arrows), and abdominal pelvic fluid/blood (red arrow). (C): The procedure was conducted by removing the mass and partly attached gastric wall with an endoscopic linear cutting stapler (EC60A, Ethicon). (D): Postoperative pathological examination showing a ruptured cavernous hemangioma with hemorrhage and thrombosis (HE x 100).
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F2
Calcified plaques had formed in the abdominal aorta, bilateral common iliac artery, bilateral internal iliac artery, and right external iliac artery, partially accompanied by mural thrombosis (Figure 2A). 2. The boundary between the hematoma and the greater curvature of the gastric wall was unclear, and abdominal pelvic fluid/blood was detected (Figure 2B). Surgery involved removal of the mass and partial attachment of the gastric wall with an endoscopic linear cutting stapler (EC60A, Ethicon) (Figure 2C). The postoperative pathological results confirmed the diagnosis of ruptured omental cavernous hemangioma accompanied by thrombosis (Figure 2D).