A case of the esophageal intramural hematoma under antithrombotic therapy

Abstract

In nearly future, the number of patients under antithrombotic therapy could be increasing. In this case report, we experienced a case of Intramural hematoma of the esophagus (IHE) under antithrombotic therapy. This is a 71-year old female with newly diagnosed as Cerebral aneurysm. She is admitted for scheduled coil embolization therapy. The patient had received antithrombotic therapy for one week before admission. After admission, the patient complained of severe epigastralgia,.and emergency enhanced CT scan showed huge IHE located from middle part of the esophagus to the upper area of the stomach. There was also pin-point visible bleeding found inside of the hematoma, by CT scan.
At the 12 days after admission, endoscopic findings showed esophageal ulcer. The patient has managed conservatively without any symptom. The patient had discharged at 21 days after admission without severe complication. Our case suggests that especially the patient under anticoagulation therapy should be considered IHE and early diagnosed with appropriate modality.