Abstract
İntroduction: Spontaneous Intramural
Esophageal Hematoma (SIEH) is a rare form of esophageal injury caused by
separation of the mucosa of the esophagus from muscle layers. The most common
forms of clinical presentation are sudden onset chest pain, dysphagia and
hematemesis. Here we present a case of SIEH presenting with hematemesis
secondary to clopidogrel use.
Case report: A 73-year-old female
patient was treated with clopidogrel in the intensive care unit because of cerebrovascular
dısease (CVD). Under this treatment, hematemesis happened so endoscopy was
performed. It showed submucosal hematom. So, clopidogrel treatment was
discontinued. Control endoscopy performed 1 week later showed no pathology
other than linear mucosal irregularity.
Discussion:
IEHs are described as esophageal apoplexy, intramural hemorrhage and intramural
dissection. Female gender, older age, presence of bleeding diathesis, and the
use of anticoagulant, antiplatelet, antitrombolitik drugs are among the
predisposing factors. Barium esophageal radiography, computed tomography, MRI
and endoscopy can be used for diagnosis. Intramural hypoechoic submucosal
lesion may be seen in endoscopy. Treatment is conservative and supportive.
Keywords
References
- 1. Hajsadeghi, S., et al., Dissecting intramural hematoma of esophagus after thrombolytic therapy: a case report. Asian Cardiovasc Thorac Ann, 2015. 23(2): p. 224-6.
- 2. Hong, M., D. Warum, and A. Karamanian, Spontaneous intramural esophageal hematoma (IEH) secondary to anticoagulation and/or thrombolysis therapy in the setting of a pulmonary embolism: a case report. J Radiol Case Rep, 2013. 7(2): p. 1-10.
- 3. Cheung, J., N. Muller, and A. Weiss, Spontaneous intramural esophageal hematoma: case report and review. Can J Gastroenterol, 2006. 20(4): p. 285-6.
- 4. Thomasset, S.C. and D.P. Berry, Spontaneous intramural esophageal hematoma. J Gastrointest Surg, 2005. 9(1): p. 155-6.
- 5. Syed, T.A., G. Salem, and J. Fazili, Spontaneous Intramural Esophageal Hematoma. Clin Gastroenterol Hepatol, 2018. 16(2): p. e19-e20.
- 6. Seneviratne, S.A., D.S. Kumara, and A. Drahaman, Spontaneous intramural oesophageal haematoma: a case report. Med J Malaysia, 2012. 67(5): p. 536-7.
Abstract
Giriş: Spontan İntramural Özofagus
Hematomu (SIEH), yemek borusunun mukozasının kas tabakalarından ayrılması
sonucu ortaya çıkan, nadir görülen bir özofagus hasarı şeklidir. En sık klinik
prezentasyon şekilleri ani başlayan göğüs ağrısı, disfaji ve hematemez
şeklindedir. Biz burda klopidogrel kullanımına sekonder gelişen, hematemez ile
prezente olan SIEH vakası sunmaktayız.
Olgu sunumu: 73 yaşında bayan
hasta, yoğun bakım ünitesinde serebrovasküler hastalık (SVH) nedeni ile klopidogrel
kullanmakta iken hematemezi olması nedeni yapılan endoskopisinde submukozal
hematom izlendi. Klopidogrel tedavisi kesilerek takip edildi. Hastanın 1 hafta
sonra yapılan kontrol endoskopisinde lineer mukozal düzensizlik dışında
patoloji izlenmedi.
Tartışma: IEH’ler, özefagus
apopleksisi, intramural kanama ve intramural diseksiyon olarak tanımlanmıştır. Kadın
cinsiyet, ileri yaş, kanama diyatezi varlığı, antikoagülan antitrombolitik ve
antiplatelet ilaçların kullanımı predispozan faktörler arasındadır. Tanıda
baryumlu özofagus grafisi, bilgisayarlı tomografi, MRI ve endoskopi
kullanılabilmektedir. Endoskopide intramural hipoekoik submukozal lezyon
görülebilir. Tedavi konservatif ve destek tedavisi şeklindedir.
Keywords
References
- 1. Hajsadeghi, S., et al., Dissecting intramural hematoma of esophagus after thrombolytic therapy: a case report. Asian Cardiovasc Thorac Ann, 2015. 23(2): p. 224-6.
- 2. Hong, M., D. Warum, and A. Karamanian, Spontaneous intramural esophageal hematoma (IEH) secondary to anticoagulation and/or thrombolysis therapy in the setting of a pulmonary embolism: a case report. J Radiol Case Rep, 2013. 7(2): p. 1-10.
- 3. Cheung, J., N. Muller, and A. Weiss, Spontaneous intramural esophageal hematoma: case report and review. Can J Gastroenterol, 2006. 20(4): p. 285-6.
- 4. Thomasset, S.C. and D.P. Berry, Spontaneous intramural esophageal hematoma. J Gastrointest Surg, 2005. 9(1): p. 155-6.
- 5. Syed, T.A., G. Salem, and J. Fazili, Spontaneous Intramural Esophageal Hematoma. Clin Gastroenterol Hepatol, 2018. 16(2): p. e19-e20.
- 6. Seneviratne, S.A., D.S. Kumara, and A. Drahaman, Spontaneous intramural oesophageal haematoma: a case report. Med J Malaysia, 2012. 67(5): p. 536-7.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 25, 2019 |
| Published in Issue | Year 2019 |