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Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome:A case report

查看全文 作　　者：Jiro [1]Oba;Daisuke [1]Usuda;Shiho [1]Tsuge;Riki [1]Sakurai;Kenji [1]Kawai;Shun [1]Matsubara;Risa [1]Tanaka;Makoto [1]Suzuki;Hayabusa [1]Takano;Shintaro [1]Shimozawa;Yuta [1]Hotchi;Kenki [1]Usami;Shungo [1]Tokunaga;Ippei [1]Osugi;Risa [1]Katou;Sakurako [1]Ito;Kentaro [1]Mishima;Akihiko [1]Kondo;Keiko [1]Mizuno;Hiroki [1]Takami;Takayuki [1,2]Komatsu;Tomohisa [1]Nomura;Manabu [1]Sugita 高影响力作者 机构地区：[1]Department of Emergency and Critical Care Medicine,Juntendo University Nerima Hospital,Nerima-ku 177-8521,Tokyo,Japan;[2]Faculty of Medicine,Juntendo University,Bunkyo-ku 113-8421,Tokyo,Japan高影响力机构 出　　处：《World Journal of Clinical Cases》索引2022年第10卷第27期,共10页高影响力期刊 摘　　要：BACKGROUND Esophageal submucosal hematoma is a rare condition.Although the exact etiology remains uncertain,vessel fragility with external factors is believed to have led to submucosal bleeding and hematoma formation;the vessel was ruptured by a sudden increase in pressure due to nausea,and the hematoma was enlarged by antiplatelet or anticoagulant therapy.Serious conditions are rare,with a better prognosis.We present the first known case of submucosal esophageal hematoma-subsequent hemorrhagic shock due to Mallory-Weiss syndrome.CASE SUMMARY A 73-year-old female underwent endovascular treatment for an unruptured cerebral aneurysm.The patient received aspirin and clopidogrel before surgery and heparin during surgery,and was well during the surgery.Several hours after returning to the ICU,she complained of chest discomfort,vomited 500 m L of fresh blood,and entered hemorrhagic shock.Esophageal submucosal hematoma with Mallory-Weiss syndrome was diagnosed through an endoscopic examination and computed tomography.In addition to a massive fluid and erythrocyte transfusion,we performed a temporary compression for hemostasis with a Sengstaken-Blakemore(S-B)tube.Afterwards,she became hemodynamically stable.On postoperative day 1,we performed an upper gastrointestinal endoscopy and confirmed no expansion of the hematoma nor any recurring bleeding;therefore,we removed the S-B tube and clipped the gastric mucosal laceration at the esophagogastric junction.We started oral intake on postoperative day 10.The patient made steady progress,and was discharged on postoperative day 33.CONCLUSION We present the first known case of submucosal esophageal hematoma subsequent hemorrhagic shock due to Mallory-Weiss syndrome. 关 键 词：Esophageal submucosal hematoma Hemorrhagic shock Mallory-Weiss syndrome Antithrombotic therapy Anticoagulant therapy Case report
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