Pancreatic mesenteric fibromatosis: A rare cause of epigastric pain with massive hemoperitoneum

Acute epigastric pain, especially in young females, is a very common cause of visits to the emergency room. We report a case of a 26-year-old woman presenting with acute epigastric tenderness initially but who was later found to have massive intra-abdominal hemoperitoneum caused by acute rupture of a tumor located over the pancreatic tail with adhesions to the stomach and transverse colon. A pancreatic malignancy with local metastasis was suspected initially. The patient was treated and recovered uneventfully. The final pathologic report revealed an extremely rare tumor called a mesenteric fibromatosis. To the best of our knowledge, this is the first reported case of a presentation of acute abdomen with hemoperitoneum as the pathologic result of pancreatic mesenteric fibromatosis.