Spontaneous Gastric Intramural Hematoma: Case Report and Literature Review

Tabbikha, Omar; Maalouf, Hani; Abou-Malhab, Christina; Hadeer, Ribal Aby; Wakim, Raja

doi:10.7759/cureus.23268

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Based on previous reports of gastric intramural hematoma including our case [4 , 5] , the mean age of the patients was in their 40s, and most of them were male; this may have been related to the presence of hemophilia in the patients’ backgrounds. Intramural gastric hematomas are relatively rare, but they are occasionally seen in patients on anticoagulation therapy or with a bleeding predisposition, such as patients with hemophilia.…”

Section: Discussionmentioning

confidence: 62%

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A case of idiopathic gastric intramural hematoma diagnosed using contrast-enhanced ultrasonography and followed up with conservative treatment

Nakamura

Manabe²,

Kato³

et al. 2022

Radiology Case Reports

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Section: Discussionmentioning

confidence: 62%

“…Many of the gastric intramural hematomas reported to date were relatively large, measuring ≥5 cm in diameter. Therefore, the possibility of a GIST cannot be completely ruled out in such patients, and surgery is performed in 39.4% of cases; this is considered to be a clinical problem [4 , 5] .…”

Section: Discussionmentioning

confidence: 99%

A case of idiopathic gastric intramural hematoma diagnosed using contrast-enhanced ultrasonography and followed up with conservative treatment

Nakamura

Manabe²,

Kato³

et al. 2022

Radiology Case Reports

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“…GIH has also been known to occur spontaneously and without a specific or clear etiology [ 26 - 28 ]. Complications include gastric outlet obstruction, as the hematoma imparts a mass effect on the pyloric sphincter, preventing physiologic evacuation of gastric contents into the small intestines.…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, a GIH can also appear similarly to an aneurysm located in the branch of the superior mesenteric artery, which can cause further diagnostic confusion [25]. GIH has also been known to occur spontaneously and without a specific or clear etiology [26][27][28].…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Gastric Intramural Hematoma Secondary to Hemorrhagic Pancreatitis

Almaguer,

Murray,

Motamedi

et al. 2023

Cureus

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Gastric intramural hematoma (GIH) is a contained hemorrhage located within the layers that comprise the wall of the stomach. It is a rare condition that has a variety of etiologies. Pancreatitis-induced GIH is an even rarer phenomenon, with only a handful of documented cases in the medical literature. In the current case, a patient presented with chronic abdominal pain for the past two months, with an acute worsening of symptoms. CT imaging confirmed a large, stable GIH with concomitant pancreatitis, likely alcohol-induced. Diagnostic laparoscopy was performed in response to worsening hemodynamic status, which confirmed hemorrhagic pancreatitis as the likely cause of the GIH formation. Jackson-Pratt (JP) drains were placed, and the patient was subsequently discharged. The patient returned one month later with an acute exacerbation of pancreatitis; however, interval improvement of the GIH was observed. The patient was transferred to outpatient care for continued conservative treatment without any further return visits.

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Spontaneous gastric hematoma as a rare cause of acute abdomen: A case report

Budimir,

Žulec,

Eljuga

et al. 2023

World J Clin Cases

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BACKGROUND Spontaneous gastric hematoma is an exceedingly rare condition characterized by the accumulation of blood within the gastric wall without any apparent iatrogenic or traumatic cause. Coagulopathies are the most frequent cause of gastric hematomas. However, other causes include amyloidosis, pancreatitis, visceral vascular aneurysms, endoscopy complications and others. The pathophysiology of spontaneous gastric hematoma is not completely understood. However, it is postulated that it is caused by disruption of submucosal vessels that leads to dissection of the muscularis layer and formation of false lumen. The rarity of this condition increases the challenge of diagnosis, and there is no standard treatment protocol. CASE SUMMARY We present the case of a spontaneous gastric hematoma in a 22-year-old male. He presented to our emergency department complaining of pain in the left flank area lasting for 2 wk. There was no history of trauma, anticoagulant medications or endoscopy procedures. His hemoglobin and hematocrit levels were slightly lower than normal. Multi-slice computed tomography, ultrasound and endoscopy confirmed a gastric intramural hematoma. We recommended conservative treatment because there was no hemodynamic instability nor significant bleeding. The patient responded well, and there were no unexpected events. At the 3-mo follow-up, the ultrasound examination revealed complete regression of the hematoma. CONCLUSION After reviewing the literature and our experience, we recommend that more of these cases should be treated conservatively. The tendency to treat these cases with potentially burdensome procedures such as total or subtotal gastrectomy should be significantly reduced.

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Spontaneous Gastric Intramural Hematoma: Case Report and Literature Review

Cited by 4 publications

References 9 publications

A case of idiopathic gastric intramural hematoma diagnosed using contrast-enhanced ultrasonography and followed up with conservative treatment

A case of idiopathic gastric intramural hematoma diagnosed using contrast-enhanced ultrasonography and followed up with conservative treatment

A Rare Case of Gastric Intramural Hematoma Secondary to Hemorrhagic Pancreatitis

Spontaneous gastric hematoma as a rare cause of acute abdomen: A case report

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