Spontaneous Intramural Hematoma of the Esophagus in a Patient Receiving Chronic Hemodialysis

Keisuke Uehara, Hiroshi Hasegawa, Seiji Ogiso, Masaya Shiomi Masato Momiyama, Tsuyoshi Igami, Shusaku Ohira, Yu Takahashi, Takeshi Amemiya and Susumu Miyazaki

Department of Surgery, Nagoya Daini Red Cross Hospital

Intramural hematoma of the esophagus is a rare disease, but its outcome is fairly good. We report a case of spontaneous intramural hematoma of the esophagus following a rectus sheath hematoma in a patient receiving chronic hemodialysis, and also review 21 cases reported in Japan. A 48-year-old woman receiving chronic hemodialysis was admitted to our hospital with a chief complaint of hematemesis. Emergent endoscopic examination revealed a submucosal mass protruding into the lumen between the midportion of the esophagus and the esophagogastric junction. The patient was diagnosed with intramural hematoma of the esophagus and treated conservatively. She became asymptomatic on the 5th hospital day. Esophagogram with gastrografin taken on the 11th hospital day showed no irregularity of the esophageal wall. In a subsequent endoscopy on the 13th hospital day, the hematoma had disappeared and a shallow ulcer due to dissection of the mucosa was observed in the lower esotphagus, which was replaced with normal mucosa by the 22nd hospital day. She was discharged free of symptoms on the 23rd hospital day.

Key words
intramural hematoma, esophagus, hemodialysis

Reprint requests
Keisuke Uehara Department of Surgery, Nagoya Daini Red Cross Hospital 2-9 Myouken-cho, Shouwa-ku Nagoya, 466-8650 JAPAN

Accepted
May 23, 2000

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