Korean J Med.  2015 Sep;89(3):317-322. 10.3904/kjm.2015.89.3.317.

A Case of a Large, Gastric Intramural Hematoma Caused by Endoscopic Mucosal Resection, and Treated with Transcatheter Arterial Embolization

• Park JJ
• Jung SW
• Ju SB
• Kim HM
• Kim JB
• Park SH
• Lee MS

• KMID: 2269004
• DOI: http://doi.org/10.3904/kjm.2015.89.3.317

Abstract

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 x 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.

Keyword

Gastric intramural hematoma; Endoscopic mucosal resection; Transcatheter arterial embolization

MeSH Terms

Abdominal Pain
Arteries
Endoscopy
Hematoma*
Hemorrhage
Humans
Proton Pumps
Pyloric Antrum
Proton Pumps