What is esophageal hematoma?

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.

What causes esophageal hematoma?

It can be precipitated by coagulopathy, trauma (foreign body ingestion or food impaction), forceful vomiting or retching [2]. It can also be iatrogenic usually secondary to esophageal instrumentation [3] or it can happen spontaneously [4].

What is boerhaave syndrome?

DEFINITION. Effort rupture of the esophagus, or Boerhaave syndrome, is a spontaneous perforation of the esophagus that results from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure (eg, severe straining or vomiting).

When should you worry about a hematoma?

Seek immediate medical care (call 911) if you suspect a hematoma due to head injury, especially if you, or the person you are with, is vomiting or experiencing confusion or loss of consciousness for even a brief moment.

What are the risks of a hematoma?

Hematomas cause swelling and inflammation. Often the inflammation and swelling cause irritation of adjacent organs and tissues, and cause the symptoms and complications of a hematoma. One common complication of all hematomas is the risk of infection.

Can an esophageal tear heal itself?

A perforation in the uppermost (neck region) part of the esophagus may heal by itself if you do not eat or drink for a period of time. In this case, you will need a stomach feeding tube or another way to get nutrients. Surgery is often needed to repair a perforation in the middle or bottom portions of the esophagus.

What causes an intramural hematoma in the esophagus?

Vomiting can lead to increased intraesophageal pressure that may result in mucosal tears (Mallory-Weiss syndrome), transmural perforation (Boerhaave syndrome), or intramural hematoma of the esophagus. The hemorrhage occurs within submucosal tissues. [ 15, 16]

How long does it take for esophageal hematoma to recur?

Long-term results are very good with conservative and supportive treatment. Intermittent odynophagia usually subsides within 2 weeks after the primary event. Recurrence is extremely rare. If the hematoma is associated with a perforation of the esophagus, septic complications (eg, mediastinitis, abscess formation) are likely to occur.

What’s the average age of an intramural hematoma?

Approximately 80% of intramural hematomas occur in women. Primarily middle-aged women are affected. In a literature review of 31 patients, the mean age was 67 years.