Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome: A case report

Figure 1 Enhanced computerized tomography performed after the patient vomited approximately 500 mL of fresh blood and entered a state of hemorrhagic shock. A: Cross section. The mid thoracic esophagus is dilated, and the esophageal lumen is filled with massive hematomas; B: Cross section. An occupying lesion with a relatively clear boundary is observed under the mucosa just above the esophagogastric (EG) junction, with partial contrast effects (orange arrow); C: Coronal section. An occupying lesion with a relatively clear boundary is observed under the mucosa just above the EG junction, with partial contrast effects (orange arrow).

Figure 2 Upper gastrointestinal endoscopy images after hematemesis. A: Middle esophagus. A longitudinal extension of reddish mucosal thickening (white asterisk) and obstructing of the esophagus are confirmed; B: Middle esophagus, temporary compression hemostasis was performed with Sengstaken-Blakemore tube (white asterisk); C: Lower esophagus, massive hematoma and laceration of gastric mucosa together with bleeding are confirmed in the esophagogastric junction (white asterisk);.

Figure 3 Upper gastrointestinal endoscopy images of postoperative course. A: One day after surgery, middle esophagus, hemostasis is confirmed; B: One day after surgery, Lower esophagus, Hematoma (white asterisk) and laceration of the gastric mucosa are confirmed in the esophagogastric (EG) junction; C: One day after surgery, EG junction, gastric mucosal laceration is clipped; D: 10 d after surgery, middle esophagus, the submucosal hematoma has been replaced by an esophageal ulcer.

Figure 4 Upper gastrointestinal endoscopy images 60 d after surgery. A: Middle esophagus, hemostasis has disappeared, and the endoscopy revealed normal findings; B: Esophagogastric junction, the esophageal ulcer has been replaced with a scar.