Silva Mario Jorge, Saiote Joana, Salvado Vera, Nunes Ana Paiva, Duarte Pedro
Gastroenterology Department, Central Lisbon Hospital Centre, Alameda de Santo António dos Capuchos, 1169-050, Lisboa, Portugal; NOVA Medical School, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal.
Gastroenterology Department, Central Lisbon Hospital Centre, Alameda de Santo António dos Capuchos, 1169-050, Lisboa, Portugal; NOVA Medical School, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal.
Am J Emerg Med. 2015 Mar;33(3):481.e1-2. doi: 10.1016/j.ajem.2014.08.069. Epub 2014 Aug 29.
Intramural dissecting hematoma is an unusual esophageal condition with a threatening presentation but excellent prognosis when managed conservatively.We report the case of an 88-year-old woman who developed an intramural hematoma of the esophagus after intravenous thrombolysis for an acute ischemic stroke. Before thrombolysis, nasogastric intubation was attempted unsuccessfully. She was kept on nil by mouth, intravenous hydration, proton pump inhibitor, antiemetics,and an antibiotic initiated 2 days before for periodontal disease. The esophageal hematoma regressed, and she resumed oral diet asymptomatically.To our knowledge, this is the first report of this type of lesion after thrombolysis for an ischemic stroke. A brief discussion and literature review are presented.
壁内夹层血肿是一种不常见的食管疾病，临床表现凶险，但保守治疗预后良好。我们报告一例88岁女性，在急性缺血性卒中静脉溶栓后发生食管壁内血肿。溶栓前，曾尝试进行鼻胃管插管，但未成功。患者禁食，接受静脉补液、质子泵抑制剂、止吐药治疗，并因牙周病于2天前开始使用抗生素。食管血肿消退，她无症状地恢复了经口饮食。据我们所知，这是缺血性卒中溶栓后此类病变的首例报告。本文进行了简要讨论并回顾了相关文献。
