Abstract
A 43-year-old Peruvian man encountered the Hanshin-Awaji eartyhquake on January 170f 1995. He suffered from"crush syndrome"and acute renal failure progressed rapidly. He was referred to our hospital on January 20 and was treated with hemodialysis. His physical condition recovered gradually, and he started drinking water after four days of hospitalization. On the next day, however, he complained of anterior chest pain and showed melena. Endoscopic examination revealed multiple hemorrhagic erosions and small hematocytic spots in the middle esophagus. With fasting and combined treatment of proton pomp inhibitor and cytoprotective agents, his chest pain and melena were improved. White coat with granular surface in the same lesion was identified by endoscopic examination performed one month later. The lesion was not stained with iodine. Pathological examination revealed a defect of the mucosa and infiltration of neutrophiles and macro phages. Thus, we diagnosed this lesion as an ulcer of middle esophagus accompanied with intermural hematomas. This is theught to be a rare case of ulcer of the middle esophagus in the course of the"crush syndrome".
