Pregnant Woman with Esophageal Achalasia complicated by a Huge Esophageal Submucosal Hematoma: A Case Report

Yuichiro Tanishima, Hideyuki Kashiwagi, Katsunori Nishikawa, Toshiyuki Sasaki, Akira Matsumoto, Fumiaki Yano, Nobuo Omura and Katsuhiko Yanaga

Department of Surgery, Jikei University School of Medicine

We report a rare case of pregnancy involving esophageal achalasia complicated by severe anemia and fetal distress due to a huge submucosal hematoma. A 32-year-old pregnant woman admitted for hematemesis and severe anemia sufferd loss of conciousness, causing fetal distress. Computed tomography and endoscopic examination detected esophageal dilation, submucosal esophageal hematoma, blood pooling in the esophageal lumen, and lower esophagus tortuosity. Emergency surgery involved a Caesarean section, Heller myotomy with Dor fundoplication, and gastrostomy. The postoperative course was uneventful, with the patient discharged on post operative day18, and the premature infant after a 3-month stay in the neonatal intensive care unit.

Key words
esophgeal achalasia, pregnancy, esophageal submucosal hematoma

Reprint requests
Yuichiro Tanishima Department of Surgery, Jikei University School of Medicine
3-25-8 Nishi-shinbashi, Minato-Ku, 105-8461 JAPAN

Accepted
June 9, 2010

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