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Uchida S, Saito H, Kuriyama K, Yoshida T, Hara K, Sakai M, Sohda M, Saeki H, Shirabe K. A case of spontaneous esophageal submucosal hematoma. Clin J Gastroenterol 2022; 15:522-525. [PMID: 35195857 DOI: 10.1007/s12328-022-01608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/10/2022] [Indexed: 11/25/2022]
Abstract
A 78-year-old man visited a nearby hospital owing to chest pain triggered by vomiting. As computed tomography revealed suspected esophageal perforation, he was referred to our hospital. Upper gastrointestinal endoscopy showed blood coagula extending from the middle intra-thoracic to the esophago-cardiac junction (ECJ), and it was diagnosed as an esophageal submucosal hematoma. Conservative therapy was initiated by fasting and discontinuing oral anticoagulants. The lesion was monitored by upper gastrointestinal endoscopy. On day 12 of the symptom appearance, the hematoma had completely disappeared and on day 22, the patient was discharged from the hospital. In most cases, esophageal submucosal hematoma has a favorable course with preservative treatment. Esophageal submucosal hematoma should be considered as one of the differential diagnoses for chest pain triggered by vomiting.
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Affiliation(s)
- Shintaro Uchida
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hideyuki Saito
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Kengo Kuriyama
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Tomonori Yoshida
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Keigo Hara
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Makoto Sakai
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Makoto Sohda
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Hiroshi Saeki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
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Alreheili KM, Almutairi M, Alsaadi A, Ahmed G, Alhejili A, AlKhatrawi T. A 2-Year-Old Boy Who Developed an Aortoesophageal Fistula After Swallowing a Button Battery, Managed Using a Novel Procedure with Vascular Plug Device as a Bridge to Definitive Surgical Repair. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931013. [PMID: 34407064 PMCID: PMC8382025 DOI: 10.12659/ajcr.931013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Patient: Male, 2-year-old
Final Diagnosis: Aortoesophageal fistula
Symptoms: Esophageal foreign body • gastrointestinal bleeding
Medication: —
Clinical Procedure: —
Specialty: Gastroenterology and Hepatology • Pediatrics and Neonatology
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Affiliation(s)
- Khalid M Alreheili
- Department of Pediatrics, Division of Gastroenterology, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Mansour Almutairi
- Department of Pediatrics, Division of Cardiology, Madinah Cardiac Centre, Madinah, Saudi Arabia
| | - Ali Alsaadi
- Department of Radiology, Division of Gastroenterology, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Ghousia Ahmed
- Department of Pediatrics, Division of Pediatric Intensive Care, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Abdulrahman Alhejili
- Department of Pediatrics, Division of Pediatric Intensive Care, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Taha AlKhatrawi
- Department of Pediatric Surgery, Maternity and Children's Hospital, Madinah, Saudi Arabia
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Sengstaken-Blakemore Tube: an extra mile. Int J Pediatr Adolesc Med 2017; 4:141-143. [PMID: 30805519 PMCID: PMC6372569 DOI: 10.1016/j.ijpam.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 09/25/2017] [Accepted: 10/11/2017] [Indexed: 12/22/2022]
Abstract
Upper gastrointestinal bleeding (UGIB) in children has multiple etiologies but fortunately is not encountered commonly by pediatricians. Aorto-esophageal fistula (AEF) in children is a rare cause of UGIB and it is mainly secondary to accidental ingestion of foreign bodies, particularly disc batteries, or after cardiothoracic surgery. In this study, we report a case of a 3-year-old child who developed de novo AEF with no prior injury to the esophagus. The child presented with massive UGIB leading to hypovolemic shock, acute kidney injury, and cardiac arrest. The torrential bleed was controlled using a Sengstaken–Blakemore Tube (SBT), which allowed urgent chest CT angiography as well as subsequent thoracotomy and repair of the fistula Unfortunately, the child succumbed to repeated cardiac arrests secondary to the renal injury and severe acidosis. This case highlights the need for the early recognition of massive UGIB in children and the requirement to make appropriately sized SBTs available in all pediatric gastroenterology units.
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Abstract
This case highlights a rare but important presentation of aorto-oesophageal fistula caused by a concealed foreign body. Primary prevention strategies are needed to address the danger associated with button batteries.
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Affiliation(s)
- Kiarash Taghavi
- Department of Paediatric Surgery and Urology, Royal Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Hobson
- Department of Paediatric Surgery and Urology, Royal Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Borzi
- Department of Paediatric Surgery and Urology, Royal Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Krieves MA, Merritt GR, Nichols CS, Schwartz LI, Campbell DN, Bruny JL, Fagan TE, Thompson ME, Ing RJ. Aortoesophageal fistula and coarctation of the aorta in a 15-year-old child. Semin Cardiothorac Vasc Anesth 2013; 17:294-7. [PMID: 24122581 DOI: 10.1177/1089253213506789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Delayed presentation of coarctation of the aorta can be associated with severe complications. A challenging case of aortoenteric fistula secondary to an aneurysm from coartation of the aorta presented with massive gastrointestinal hemorrhage. The clinical management of this patient and a review of the literature are presented.
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Affiliation(s)
- Michael A Krieves
- 1Children's Hospital Colorado and University of Colorado Denver, Aurora, CO, USA
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Panda SS, Agarwala S, Kabra SK, Ray R, Sugandhi N, Bhat AS, Lodha R, Joshi P, Bisoi AK, Arora A, Gupta AK. Aortoesophageal fistula in a child. J Indian Assoc Pediatr Surg 2013; 18:124-6. [PMID: 24019646 PMCID: PMC3760313 DOI: 10.4103/0971-9261.116051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aortoesophageal fistulae (AEF) are rare and are associated with very high mortality. Foreign body ingestions remain the commonest cause of AEF seen in children. However in a clinical setting of tuberculosis and massive upper GI bleed, an AEF secondary to tuberculosis should be kept in mind. An early strong clinical suspicion with good quality imaging and endoscopic evaluation and timely aggressive surgical intervention helps offer the best possible management for this life threatening disorder. Our case is a 10-year-old boy who presented to the pediatric emergency with massive bouts of haemetemesis and was investigated and managed by multidisciplinary team effort in the emergency setting.
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Affiliation(s)
- Shasanka Shekhar Panda
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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