Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome: A case report

Table 1 Routine laboratory examination of the patient, taken in a state of hemorrhagic shock

Parameter (units)	Measured value	Normal value
White blood cell (109/L)	12.9	3.6-8.9
Neu (%)	83.4	37-72
Lym (%)	13.4	25-48
Mon (%)	2.6	2-12
Eos (%)	0.4	1-9
Bas (%)	0.2	0-2
Red blood cell (1012/L)	3.13	3.8-5.04
Platelet (109/L)	221	153-346
Aspartate transaminase (IU/L)	14	5-37
Alanine aminotransferase (IU/L)	12	6-43
Lactic acid dehydrogenase (IU/L)	164	119-221
Alkaline phosphatase (IU/L)	159	110-348
Gamma-glutamyl transpeptidase (IU/L)	15	0-75
Total bilirubin (mg/dL)	0.5	0.4-1.2
Total protein (g/dL)	7.4	6.5-8.5
Albumin (g/dL)	4.5	3.8-5.2
Creatine kinase (U/L)	95	47-200
Blood urea nitrogen (mg/dL)	13	9-21
Creatinine (mg/dL)	0.76	0.5-0.8
Amylase (IU/L)	98	43-124
Sodium (mEq/L)	140	135-145
Potassium (mEq/L)	3.3	3.5-5
Chloride (mEq/L)	110	96-107
C-reactive protein (mg/dL)	0.03	0-0.29
Plasma glucose (mg/dL)	156	65-109
Activated partial thromboplastin time (Seconds)	24.8	23-36
Prothrombin time-international normalized ratio	1.1	0.85-1.15
D-dimer (μg/mL)	1.1	0-1

Table 2 Summary of prior reported cases of esophageal submucosal hematoma

Case No.	Year	Age	Sex	Underlying disease	Antiplatelet therapy	Anticoagulation therapy	Symptoms	Imaging findings	Complications	Prognosis	Prognosis time	Ref.
1	1998	64	M	Ischemic heart disease	None	None	Retrostemal pain and coffee-ground vomitus	CT: A non-enhancing low-density submucosal columnar lesion in the mid- and lower oesophagus consistent with a submucosal haematoma. MRI: Intermediate signal intensity on T1-weighted images and hyperintense signal on T2-weighted images of this lesion.	None	Recovered	N/A	Yuen et al[9]
2	2000	67	M	Unruptured cerebral aneurysm	None	Heparin	Hematemesis	CT: A longitudinal water density mass without enhancement in the distal half of the esophageal lumen. It extended from about 3 cm below the level of the tracheal carina to the esophagocardiac junction.	None	Recovered	N/A	Yamashita et al[10]
3	2001	84	F	Dissecting aortic aneurysm	None	None	Chest discomfort and hematemesis	CT: Partial thickness of the esophageal wall which was not enhanced by contrast medium.	None	Recovered	N/A	Kise et al[11]
4	2010	68	F	Cerebrovascular disease	A	None	Hematemesis and retrostemal pain	None	None	Recovered	N/A	Zimmer et al[12]
5	2013	32	F	Neurofibromatosis type 1	None	None	Sever central chest pain and interscapular pain associated with dysphagia	N/A	Massive bleeding with hypovolemic shock due to dissecting intramural hematoma of the esophagus	Dead	6 hours	Pomara et al[13]
6	2014	74	M	Cerebral infarction and chronic hepatitis C	A	None	Hematemesis	None	None	Recovered	N/A	Oe et al[2]
7	2016	70	F	Unruptured cerebral aneurysm	A	Heparin	Epigastric pain and nausea	Unknown	Unknown	Recovered	N/A	Fujimoto et al[7]
8	2017	81	M	Idiopathic thrombocytopenic purpura	None	None	Chest pain and dysphagia	CT: A 17-cm long segment of homogeneous, soft tissue like density in the mid-to-distal esophagus with smooth eccentric configuration causing luminal narrowing. The maximal esophageal wall measures approximately 26 mm in thickness. Upper gastrointestinal contrast study: A large eccentric luminal narrowing caused by a mural wall compression of the mid-to-distal esophagus, confirming the submucosal hematoma.	None	Recovered	N/A	Sharma et al[14]
9	2017	85	F	Atrial fibrillation	None	Dabigatran	Hemoptysis	Unknown	Unknown	Recovered	N/A	Trip et al[15]
10	2017	75	F	Unruptured cerebral aneurysm	A+C	Heparin + Argatroban	Hematemesis	CT: Dilatation of the entire esophagus and the soft tissue shadow filled on the dorsal side that was ventrally displacing the lumen.	None	Recovered	N/A	Ito et al[16]
11	2019	65	F	Unruptured cerebral aneurysm	A	Heparin	Hematemesis	Unknown	Unknown	Recovered	N/A	Fujii et al[5]
12	2019	73	F	Unruptured cerebral aneurysm	A+C	Heparin	Epigastric pain and hematemesis	Unknown	Unknown	Recovered	N/A	Fujii et al[5]
13	2019	65	F	Unruptured cerebral aneurysm	A+C	Heparin	Epigastric pain	Unknown	Unknown	Recovered	N/A	Fujii et al[5]
14	2020	73	F	Unruptured cerebral aneurysm	A+C	Heparin	Hematemesis	CT: A dilatation from the middle to lower esophagus, and that the esophageal lumen was almost entirely filled with hematomas. An occupying lesion with a relatively clear boundary was observed under the mucosa at the esophagogastric junction, which had partial contrast effects.	None	Recovered	N/A	N/A

CT: Computed tomography; M: Male; F: Female; A: Aspirin; T: Ticlopidine; C: Clopidogrel; N/A: Not applicable.