Verma Samman, Gupta Prashant, Dutta Amitava, Gupta Pankaj, Sharma Vishal
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Cardiovasc Thorac Res. 2022;14(2):144-146. doi: 10.34172/jcvtr.2022.11. Epub 2022 Apr 6.
Esophageal Intramural Haematoma (EIH) is a rare entity usually caused by repeated emesis or trauma. It is diagnosed on the basis of upper gastrointestinal endoscopy and radiology. Treatment is conservative unless hemodynamic instability prevails. Use of anticoagulation or thrombolytic therapy is believed to be a risk factor rather than a causative etiology. However, a review of literature shows only few cases occurring post-thrombolysis. We report about a patient of myocardial infarction who was thrombolyzed with streptokinase. He developed hematemesis and dysphagia a few hours after thrombolysis despite ECG resolution of his ST elevation. He was diagnosed to have EIH on basis of endoscopic and computed tomographic findings. His symptoms improved within two weeks, and a repeat UGIE showed resolution of the hematoma.
食管壁内血肿（EIH）是一种罕见的病症，通常由反复呕吐或外伤引起。它通过上消化道内镜检查和放射学检查来诊断。除非存在血流动力学不稳定的情况，否则治疗是保守的。抗凝或溶栓治疗被认为是一个风险因素，而非病因。然而，文献综述显示溶栓后仅发生少数病例。我们报告了一名接受链激酶溶栓治疗的心肌梗死患者。尽管溶栓后心电图显示ST段抬高已缓解，但他在溶栓后数小时出现了呕血和吞咽困难。根据内镜和计算机断层扫描结果，他被诊断为食管壁内血肿。他的症状在两周内有所改善，重复上消化道内镜检查显示血肿已消退。
