Takasumi M, Hikichi T, Takagi T, Sato M, Suzuki R, Watanabe K, Nakamura J, Sugimoto M, Waragai Y, Kikuchi H, Konno N, Watanabe H, Obara K, Ohira H. Endoscopic therapy for esophageal hematoma with blue rubber bleb nevus syndrome. World J Gastrointest Endosc 2014; 6(12): 630-634 [PMID: 25512774 DOI: 10.4253/wjge.v6.i12.630]
Corresponding Author of This Article
Takuto Hikichi, MD, PhD, Associate Professor, Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima 960-1295, Japan. takuto@fmu.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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World J Gastrointest Endosc. Dec 16, 2014; 6(12): 630-634 Published online Dec 16, 2014. doi: 10.4253/wjge.v6.i12.630
Endoscopic therapy for esophageal hematoma with blue rubber bleb nevus syndrome
Mika Takasumi, Takuto Hikichi, Tadayuki Takagi, Masaki Sato, Rei Suzuki, Ko Watanabe, Jun Nakamura, Mitsuru Sugimoto, Yuichi Waragai, Hitomi Kikuchi, Naoki Konno, Hiroshi Watanabe, Katsutoshi Obara, Hiromasa Ohira
Mika Takasumi, Tadayuki Takagi, Masaki Sato, Rei Suzuki, Jun Nakamura, Mitsuru Sugimoto, Yuichi Waragai, Hitomi Kikuchi, Naoki Konno, Hiroshi Watanabe, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Takuto Hikichi, Ko Watanabe, Katsutoshi Obara, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1295, Japan
Author contributions: Sato M and Watanabe K managed the patients; Takagi T and Watanabe K performed the endoscopic examination; Suzuki R, Nakamura J, Sugimoto M, Waragai Y, Kikuchi H and Konno N provided clinical advice; Takasumi M and Hikichi T collected the data and wrote the paper; Hikichi T revised the paper; Obara K, Watanabe H and Ohira H supervised the report; all authors approved the final manuscript for publication.
Correspondence to: Takuto Hikichi, MD, PhD, Associate Professor, Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima 960-1295, Japan. takuto@fmu.ac.jp
Telephone: +81-24-5471583 Fax: +81-24-5471586
Received: August 9, 2014 Revised: October 8, 2014 Accepted: October 28, 2014 Published online: December 16, 2014 Processing time: 131 Days and 5.9 Hours
Abstract
A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome (BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestinal (GI) tract but her GI tract had never been examined. An upper gastrointestinal endoscopy revealed a large bleeding esophageal hematoma positioned between the thoracic esophagus and the gastric cardia. An endoscopic injection of polidocanol was used to stop the hematoma from bleeding. The hematoma was incised using the injection needle to reduce the pressure within it. Finally, argon plasma coagulation (APC) was applied to the edge of the incision. The esophageal hematoma disappeared seven days later. Two months after the endoscopic therapy, the esophageal ulcer healed and the hemangioma did not relapse. This rare case of a large esophageal hematoma originating from a hemangioma with BRBNS was treated using a combination of endoscopic therapy with polidocanol injection, incision, and APC.
Core tip: A patient with a large hemorrhagic esophageal hematoma complicated with blue rubber bleb nevus syndrome was treated using endoscopic injection with polidocanol and incision with an injection needle. The hematoma was then treated with argon plasma coagulation.
