부산대학교 도서관

A 63-year-old male was admitted after neurosurgery to treat right putaminal hemorrhage and while restarting antithrombotic medications for atrial fibrillation, abdominal distention and blood pressure decrease were observed. CT showed ascites and extravasation of contrast agent around the splenic flexure of the colon. Emergency laparotomy was performed, bloody ascites and a hematoma between the omentum and the transverse mosocolon were revealed. Upon removal of the hematoma, oozing from the omentum was observed yet there were no signs of another active bleeding. Since no responsible blood vessel was confirmed, the surgery was completed with open abdomen management （OAM） due to concerns about postoperative bleeding. Second-stage surgery was performed on the following day, and the abdomen was closed after confirmation of hemostasis. Second-stage surgery with OAM is also an option when the source of bleeding is uncertain and the risk of postoperative bleeding is high.