倉科 憲太郎

The patient was a 75-year-old man. Under a diagnosis of angina pectoris, he was being treated with aspirin and ticlopidine hydrochloride at a local clinic. Severe postprandial pharyngeal/thoracic pain and hematemesis occurred. Upper digestive tract endoscopy revealed an extensive submucosal hematoma involving the esophageal orifice and cardia. Computed tomography (CT) scan did not show aortic dissociation or mediastinal emphysema. Antiplatelet therapy was discontinued, and follow-up was continued by fasting and conservative treatment with an H2-blocker. Ten days after onset, endoscopy showed the disappearance of the hematoma, and ingestion was started. Twenty-two days after onset, endoscopy revealed regeneration and cicatrization of the esophageal mucosa. In a detailed examination of heart diseases, angina pectoris was ruled out therefore, antiplatelet therapy was discontinued. There has been no recurrent esophageal submucosal hematoma for 4 years of follow-up. © Japan Esophageal Society and Springer-Verlag 2005.