Heterotopic Mesenteric Ossification After a Ruptured Abdominal Aortic Aneurism: Case Report With a Review of Literatures

Author:

Honjo Hiroaki1,Kumagai Youichi1,Ishiguro Toru1,Imaizumi Hideko1,Ono Tomojiro1,Suzuki Okihide1,Ito Tetsuya1,Haga Norihiro1,Kuwabara Kohki1,Sobajima Jun1,Kumamoto Kensuke1,Ishibashi Keiichiro1,Baba Hiroyuki1,Sato Osamu2,Ishida Hideyuki1,Kuwano Hiroyuki3

Affiliation:

1. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan

2. Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan

3. Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan

Abstract

Abstract Heterotopic mesenteric ossification (HMO) is a rare disease that results in intra-abdominal ossification of unknown origin. An 88-year-old man developed an intestinal obstruction 2 weeks after undergoing an operation for a ruptured abdominal aortic aneurysm, resulting in intestinal obstructions those did not improved concervatively. During relaparotomy performed 30 days after the first operation, hard adhesions of the small intestine and mesentery were found; these adhesions were difficult to separate without damaging the serosa of the small intestine. We removed 240cm of the small intestine and performed a jejuno-ileo anastomosis. Microscopically, trabecular bone tissue had increased irregularly in the fat tissue of the nodules with fibrosis, which were partially lined with osteoblasts. Accordingly, we histopathologically diagnosed the patient as having HMO. The patient was treated with NSAIDs and cimetidine to prevent the recurrence of HMO. No signs of recurrence have occurred as of one year after the second operation.

Publisher

International College of Surgeons

Subject

Surgery

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