Wu JJ, Chen D, Liu D, Zhong DF. Huge esophagogastric submucosal hematoma associated with arterial malformations: A case report. World J Gastrointest Endosc 2026; 18(2): 115745 [DOI: 10.4253/wjge.v18.i2.115745]
Corresponding Author of This Article
Ding-Fu Zhong, Chief Physician, Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, No. 267 Danxi Road, Jinhua 213000, Zhejiang Province, China. 18757923011@sohu.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Feb 16, 2026; 18(2): 115745 Published online Feb 16, 2026. doi: 10.4253/wjge.v18.i2.115745
Huge esophagogastric submucosal hematoma associated with arterial malformations: A case report
Jia-Jia Wu, Dan Chen, Dong Liu, Ding-Fu Zhong
Jia-Jia Wu, Dan Chen, Dong Liu, Ding-Fu Zhong, Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, Jinhua 213000, Zhejiang Province, China
Co-first authors: Jia-Jia Wu and Dan Chen.
Author contributions: Wu JJ and Chen D contributed equally to this manuscript and are co-first authors; Wu JJ contributed to the original draft; Chen D and Zhong DF contributed to the conceptualization and validation; Liu D contributed to the review and editing; Zhong DF contributed to the supervision; Wu JJ and Zhong DF wrote the review and edited; Liu D and Zhong DF contributed to the visualization.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ding-Fu Zhong, Chief Physician, Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, No. 267 Danxi Road, Jinhua 213000, Zhejiang Province, China. 18757923011@sohu.com
Received: October 24, 2025 Revised: November 25, 2025 Accepted: December 23, 2025 Published online: February 16, 2026 Processing time: 103 Days and 12.8 Hours
Abstract
BACKGROUND
Esophageal or gastric submucosal hematoma is a rare condition. Esophageal and gastric submucosal hematomas rarely coexist, with only a few cases reported worldwide to date. Some of these gastric and esophageal submucosal hematomas were caused by pancreatitis, peptic ulcers, spontaneous hematomas, and endoscopic therapy, and there are few reports of gastric or esophageal submucosal hematomas related to vascular malformations.
CASE SUMMARY
We present the case of a 57-year-old male who had repeated episodes of nausea and vomiting for 2 days. Physical examination was unremarkable. Complete blood count revealed moderate anemia and elevated inflammatory markers. A gastroscopy revealed esophageal stricture 40 centimeter from the incisors. Computed tomography showed mixed high-density mass opacity extending from the esophagus to the lesser curvature of the stomach suggestive of esophageal and gastric submucosal hematomas. On contrast-enhanced scanning, a vascular malformation was seen in the left gastric artery. Active hemorrhage in the hematoma area was also observed. Vascular embolization of the malformed arteries was performed first, followed by conservative treatment of the hematomas. The patient’s symptoms were relieved and the hematomas were reduced.
CONCLUSION
A ruptured vascular malformation represents an unusual cause of esophageal and gastric submucosal hematomas, conservative treatment following interventional therapy is an effective treatment option.
Core Tip: Submucosal hematoma of the stomach or esophagus is rare and can result due to endoscopic therapy, coagulopathy, trauma, anticoagulation therapy, or repeated vomiting. The presence of both esophageal and gastric submucosal hematomas is rare. We present a 57-year-old male with huge gastric and esophageal submucosal hematomas. Endoscopy showed esophageal stenosis; computed tomography confirmed the diagnosis of gastric and esophageal submucosal hematomas associated with arterial malformations. The patient has a history of hypertension. The appearance of vascular malformations in the patient may be due to long-term hypertension causing endothelial damage in the blood vessels. Vascular embolization of the malformed arteries was performed first, followed by conservative treatment of the hematomas. The patient’s symptoms were relieved, and the hematomas were reduced.
