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KMID : 0882420150890030317
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Korean Journal of Medicine
2015 Volume.89 No. 3 p.317 ~ p.322
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A Case of a Large, Gastric Intramural Hematoma Caused by Endoscopic Mucosal Resection, and Treated with Transcatheter Arterial Embolization
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Park Jin-Ju
Jung Sung-Won
Ju Sung-Bae
Kim Han-Myun
Kim Jin-Bae
Park Sang-Hoon
Lee Myung-Seok
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Abstract
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Only two cases of gastric intramural hematoma (IMH) caused by endoscopic mucosal resection (EMR) have been reported to date. This is the first reported case of gastric IMH caused by EMR, treatment of which required hemoclipping and transcatheter arterial embolization. The patient had a normal coagulation profile and no relevant medical history. About 8 h after completing the EMR, the patient vomited approximately 150 mL fresh blood and complained of abdominal pain. Endoscopy showed a 3 × 7 cm hematoma with active surface bleeding in the gastric antrum. Hemoclipping of the bleeding site on the surface and transcatheter arterial embolization of the left gastric artery were performed. Thereafter, conservative management including administration of a proton pump inhibitor was performed, and the lesion resolved. A review of relevant previous cases and this case suggested vessel damage secondary to the submucosal injection itself to be a reasonable causative mechanism for the gastric IMH.
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KEYWORD
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Gastric intramural hematoma, Endoscopic mucosal resection, Transcatheter arterial embolization
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