Submucosal hemorrhage of the esophagus: a case report.

Risako Kojima, Shinsuke Takeno, Makoto Ikenoue, Teru Chiyotanda, Yusuke Araki, Kousei Tashiro, Fumiaki Kawano, Atsushi Nanashima, Kouji Furukawa
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Abstract

Background: Submucosal hemorrhage of the esophagus is relatively rare and the course of this disease remains unclear. We report a case of this disease.

Case presentation: The patient was a 68-year-old man who visited a clinic complaining of sudden-onset epigastric and back pain. He had been taking warfarin and a statin due to non-obstructive hypertrophic cardiomyopathy, right subclavian artery stenosis, and chronic atrial fibrillation. Contrast-enhanced computed tomography showed esophageal submucosal hemorrhage. Detailed endoscopic examination was difficult because of the massive hemorrhage and progressive esophageal mucosal edema. He was transferred to our hospital due to progression of anemia. Fortunately, hemorrhagic anemia showed no progression with conservative fasting therapy after admission to our hospital. Esophageal mucosa over the submucosal hemorrhage detached and regenerative tissue was observed on endoscopic examination 1 week later.

Conclusions: Esophageal submucosal hemorrhage should be included among the differential diagnoses for patients presenting with chest and back pain.

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食道粘膜下出血:病例报告。
背景:食管粘膜下出血相对罕见,其病程仍不清楚。我们报告了一例这种疾病:患者是一名 68 岁的男性,主诉突然发作的上腹部和背部疼痛。由于患有非梗阻性肥厚型心肌病、右锁骨下动脉狭窄和慢性心房颤动,他一直在服用华法林和他汀类药物。对比增强计算机断层扫描显示食管粘膜下出血。由于大量出血和进行性食管粘膜水肿,很难进行详细的内镜检查。由于贫血加重,他被转到我们医院。幸运的是,入院后经过保守的禁食治疗,失血性贫血没有恶化。1 周后,内镜检查发现粘膜下出血处的食管粘膜脱落,并出现再生组织:结论:食管粘膜下出血应作为胸背部疼痛患者的鉴别诊断之一。
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