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+An 82-year-old male was admitted in our outside hospital’s emergency room due to abdominal pain and faint.
+He had a previous history of auricular fibrillation in treatment with a dicumarinic anticoagulant and a previous episode of abdominal pain which was diagnosed as spontaneous mesenchimal haematoma and treated non operatively.
+He denied any kind of trauma, and had no hematemesis or melena.
+At physical examination the patient was stable and suffered from intense pain at the right lower abdomen with no defense.
+Blood tests showed a haemoglobin level of 10 g/dl.
+Coagulation was altered as expected.
+CT scan showed massive hemoperitoneum (Figure 1) and the already known mesenteric hematoma (Figure 2).
+Assuming the diagnosis of expansive mesenteric hematoma plus ongoing bleeding a laparotomy was performed.
+During first exploration, 3 liters of fresh and old blood clots were found.
+At 90cm from the ileocecal valve a torsionated and perforated meckel diverticulum with intradiverticular bleeding was found (Figure 3) and a diverticular resection was performed.
+The postoperatory was uneventful and the patient was discharged home at the 9th postoperative day.