A Case of Spontaneous Submucosal Hematoma of the Esophagus associated with Mallory-Weiss Tear following Laparoscopic Cholecystectomy

Hidefumi Tsunozaki, Hideaki Iseki, Mai Wakabayashi, Mikiko Hayashi, Hirotoshi Maruo and Shin-ichirou Kume

Department of Surgery, Toshiba General Hospital

Spontaneous submucosal hematoma of the esophagus (SSHE) is an uncommon condition rarely combined with a Mallory-Weiss tear. A 68-year-old woman diagnosed with cholecystolithiasis and choledocholithiasis underwent endoscopic sphincterotomy and removal of bile duct stones, followed by laparoscopic cholecystectomy aggravated by an atrophic gallbladder. Early on postoperative day (POD) 1, she suffered a coughing spell followed by hematemesis of 50 ml. Upper gastrointestinal endoscopy on the same day showed a submucosal hematoma in the posterior wall of the lower esophagus extending to the cardia, where a mucosal laceration was noted. She was diagnosed with SSHE associated with a Mallory-Weiss tear, and was treated conservatively. The clinical course was uneventful and healing of the hematoma and laceration was confirmed endoscopically.

Key words
spontaneous submucosal hematoma, esophagus, Mallory-Weiss tear

Reprint requests
Hidefumi Tsunozaki Department of Surgery, Toshiba General Hospital
6-3-22 Higashi-Oi, Shinagawa-ku, 140-8522 JAPAN

Accepted
December 16, 2009

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