Hematoma gigante esófago-gástrico

A belly of blood: A case report describing surgical intervention in a gastric intramural haematoma precipitated by therapeutic endoscopy in an anticoagulated patient

“…From our analysis, most cases as a result of coagulopathy and fish bone ingestion were treated successfully with medical and supportive measures. Two cases out of 17 cases caused by coagulopathy were resolved by transarterial catheter embolization after bleeding was isolated to the left gastric arteries [8] , [12] . One case caused by focal pancreatitis benefited from percutaneous aspiration of the established haematoma [45] .…”

“…In gastric intramural haematomas, a review of the literature suggests that the most common aetiology is coagulopathy, with or without contribution by peptic ulcer disease. This is most commonly related to use of anticoagulation [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , less commonly in patients with haemophilia [16] , [17] , [18] , [19] , and one case described a patient with thrombocytopenia from myelofibrosis [20] . Other causes include peptic ulcer disease [21] , [22] , [23] , vascular aneurysms [24] , [25] , [26] , [27] , fish bone ingestion [28] , [29] , as a complication of endoscopy [30] , [31] , [32] , [33] , [34] , [35] , [36] , spontaneous and idiopathic cases [37] , [38] , [39] , [40] , [41] , and other isolated cases related to amyloidosis [42] , [43] , [44] , pancreatitis [45] , Ehlers-Danlos syndrome [46] , splenic rupture [47] , and one case describing haematoma after splenectomy for idiopathic thrombocytopenic purpura [48] .…”