Background: Gastric intramural hematoma is an uncommon gastric wall lesion. Accurate diagnosis is difficult because imaging findings resemble those of submucosal tumors.
Case Presentation: An 83-year-old man who had been receiving edoxaban for atrial fibrillation was admitted with hematemesis. Contrast-enhanced computed tomography revealed an intramural mass in the gastric body with an elevated high-density fluid level in the delayed phase. Endoscopy revealed a submucosal tumorlike protrusion with blood clots. Endoscopic ultrasonography revealed a heterogeneous hypoechoic lesion in the third and fourth layers with pulsatile blood flow on Color Doppler imaging. Emergency distal gastrectomy was performed. Histopathological examination confirmed intramural hematoma with no neoplastic disease.
Conclusions: Endoscopic ultrasonography with Color Doppler imaging is useful for evaluating vascular involvement in bleeding gastric submucosal lesions and selecting an appropriate treatment strategy.
