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©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 7, 2009; 15(41): 5232-5235
Published online Nov 7, 2009. doi: 10.3748/wjg.15.5232
Published online Nov 7, 2009. doi: 10.3748/wjg.15.5232
Recurrent massive bleeding due to dissecting intramural hematoma of the esophagus: Treatment with therapeutic angiography
Jaejun Shim, Jae Young Jang, Young Hwangbo, Seok Ho Dong, Hyo Jong Kim, Byung-Ho Kim, Young Woon Chang, Rin Chang, Department of Internal Medicine, Kyung Hee University School of Medicine, Hoegi-dong 1, Dongdaemoon-gu, Seoul 130-702, South Korea
Joo Hyeong Oh, Department of Diagnostic Radiology, Kyung Hee University School of Medicine, Hoegi-dong 1, Dongdaemoon-gu, Seoul 130-702, South Korea
Author contributions: Jang JY, Oh JH and Hwangbo Y designed the procedure and took part in patient management; Shim J and Hwangbo Y analyzed the data; Shim J wrote the paper; all the authors discussed the results and commented on the manuscript.
Correspondence to: Jae Young Jang, MD, Department of Internal Medicine, Kyung Hee University School of Medicine, Hoegi-dong 1, Dongdaemoon-gu, Seoul 130-702, South Korea. jyjang@khu.ac.kr
Telephone: +82-2-9588248 Fax: +82-2-9681848
Received: August 5, 2009
Revised: September 8, 2009
Accepted: September 15, 2009
Published online: November 7, 2009
Revised: September 8, 2009
Accepted: September 15, 2009
Published online: November 7, 2009
Abstract
Spontaneous or traumatic intramural bleeding of the esophagus, which is often associated with overlying mucosal dissection, constitutes a rare spectrum of esophageal injury called dissecting intramural hematoma of the esophagus (DIHE). Chest pain, swallowing difficulty, and minor hematemesis are common, which resolve spontaneously in most cases. This case report describes a patient with spontaneous DIHE with recurrent massive bleeding which required critical management and highlights a potential role for therapeutic angiography as an alternative to surgery.
Keywords: Esophagus; Intramural hematoma; Therapeutic angiography