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Case Reports in Obstetrics and Gynecology
Volume 2017, Article ID 6304194, 4 pages
https://doi.org/10.1155/2017/6304194
Case Report

Intramural Hematoma of the Esophagus Complicating Severe Preeclampsia

1Department of Surgical, Odontostomatological and Maternal and Child Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
2Department of Medicine and Gastroenterology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy

Correspondence should be addressed to Giovanni Zanconato; ti.rvinu@otanocnaz.innavoig

Received 5 January 2017; Revised 22 April 2017; Accepted 27 April 2017; Published 18 May 2017

Academic Editor: Akihide Ohkuchi

Copyright © 2017 Simone Garzon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses. Intramural hematoma of the esophagus is generally benign and most patients recover fully with conservative treatment. Bleeding can be managed medically unless in hemodynamically unstable patients, for whom surgical or angiographic treatment may be attempted; only rarely esophageal obstruction requires endoscopic decompression. We report an unusual case of esophageal hematoma, presenting in a young preeclamptic woman after surgical delivery of a preterm twin pregnancy, with a favorable outcome following medical management.