Endoscopy 2014; 46(S 01): E203
DOI: 10.1055/s-0034-1365391
Cases and Techniques Library (CTL)
© Georg Thieme Verlag KG Stuttgart · New York

Esophageal hematoma caused by foreign body ingestion

Na Li
Department of Gastroenterology, The Military General Hospital of Beijing PLA, Beijing, China
,
Xiao-jun Zhao
Department of Gastroenterology, The Military General Hospital of Beijing PLA, Beijing, China
,
Dong-liang Yu
Department of Gastroenterology, The Military General Hospital of Beijing PLA, Beijing, China
,
Xin Wang
Department of Gastroenterology, The Military General Hospital of Beijing PLA, Beijing, China
,
Jian-qiu Sheng
Department of Gastroenterology, The Military General Hospital of Beijing PLA, Beijing, China
› Author Affiliations
Further Information

Corresponding author

Jian-qiu Sheng, MD
Department of Gastroenterology
The Military General Hospital of Beijing PLA
Nanmencang 5#
Dongcheng District
Beijing 100700
China   

Publication History

Publication Date:
22 April 2014 (online)

 

A 51-year-old man was admitted to our hospital with hematemesis after swallowing a chicken bone. An endoscopy was performed, which showed a large submucosal hematoma in the esophagus, which extended from 15 cm down to the esophagogastric junction. The esophageal lumen was occupied by the hematoma. No active bleeding or foreign body was seen ([Fig. 1]; [Video 1]).

Zoom Image
Fig. 1 Endoscopic images showing a large submucosal hematoma in the esophagus, extending from 15 cm down to the esophagogastric junction.


Quality:
Endoscopy at presentation showing a large submucosal hematoma in the esophagus, which extended from 15 cm down to the esophagogastric junction. No active bleeding or foreign body was seen.

The findings on examination and standard laboratory testing, including coagulation parameters and platelet count, were otherwise within normal limits. The patient was recommenced on a liquid diet on the third day after his admission. A follow-up endoscopy performed 1 week later showed marked improvement in the esophageal hematoma ([Fig. 2]).

Zoom Image
Fig. 2 Follow-up endoscopy 1 week later showing marked improvement in the esophageal hematoma.

Esophageal hematoma is an uncommon condition. Patients often present with acute odynophagia or retrosternal pain. Possible differential diagnoses that should be considered include Mallory–Weiss mucosal tear, esophageal perforation, Boerhaave’s transmural rupture, aortoesophageal fistula, rupture of esophageal varices, esophagitis, malignant tumors, acute myocardial infarction, pulmonary embolism, and aortic dissection. Early diagnosis is important to determine the severity of the problem and exclude life-threatening disorders [1].

We report herein on one patient with esophageal hematoma caused by ingestion of a foreign body. Hematemesis is a relatively infrequent initial symptom of esophageal hematoma. Biopsy of such lesions must be avoided because of the obvious potential risk of bleeding. The usual mode of treatment is therefore watchful waiting, and most patients will do better without any intervention [2]. With conservative treatment alone, esophageal hematomas generally resolve within a few weeks.

Endoscopy_UCTN_Code_CCL_1AB_2AC_3AG


#

Competing interests: None

  • References

  • 1 Lu MS, Liu YH, Liu HP et al. Spontaneous intramural esophageal hematoma. Ann Thorac Surg 2004; 78: 343-345
  • 2 Hirano K, Yamamichi N, Fujishiro M et al. Education and Imaging. Gastrointestinal: esophageal hematoma: a rare cause of upper gastrointestinal bleeding. J Gastroenterol Hepatol 2012; 27: 1642

Corresponding author

Jian-qiu Sheng, MD
Department of Gastroenterology
The Military General Hospital of Beijing PLA
Nanmencang 5#
Dongcheng District
Beijing 100700
China   

  • References

  • 1 Lu MS, Liu YH, Liu HP et al. Spontaneous intramural esophageal hematoma. Ann Thorac Surg 2004; 78: 343-345
  • 2 Hirano K, Yamamichi N, Fujishiro M et al. Education and Imaging. Gastrointestinal: esophageal hematoma: a rare cause of upper gastrointestinal bleeding. J Gastroenterol Hepatol 2012; 27: 1642

Zoom Image
Fig. 1 Endoscopic images showing a large submucosal hematoma in the esophagus, extending from 15 cm down to the esophagogastric junction.
Zoom Image
Fig. 2 Follow-up endoscopy 1 week later showing marked improvement in the esophageal hematoma.