A Case of Spontaneous Intramural Hematoma of the Esophagus Following Laparoscopic Cholecystectomy

Takashi Iwamoto, Tsunekazu Mizushima, Toshikazu Ito, Hitoshi Mizuno, Masanori Hoki, Yasuaki Miyazaki, Hideto Ozawa, Takashi Kanou, Yasuhiro Nakamori and Kazuhiro Iwase

Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital

Spontaneous esophageal intramural hematoma is rare, with only 44 cases reported previously in Japan. We report such a case of the esophagus following laparoscopic cholecystectomy. A 72-year-old man underwent laparoscopic cholecystectomy for cholecystolithiasis. After extubation, the patient reported chest pain. Emergency computed tomography (CT) showed no obvious thrombus in the pulmonary artery, but did show fluid collection in the esophagus and stomach. He vomited old blood 10 minutes later following insertion of a gastric suction tube. Emergency gastrointestinal endoscopy showed a submucosal hematoma on the posterior wall of the lower esophagus. The subsequent clinical course was uneventful after conservative treatment with a proton pump inhibiter was started.

Key words
spontaneous intramural hematoma, esophagus, laparoscopic cholecystectomy

Reprint requests
Tsunekazu Mizushima Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital
2-23 Rinku Ohrai Kita, Izumisano, 598-0048 JAPAN

Accepted
November 22, 2006

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