Huge esophagogastric submucosal hematoma associated with arterial malformations: A case report

Esophageal or gastric submucosal hematoma is a rare condition. Esophageal and gastric submucosal hematomas rarely coexist, with only a few cases reported worldwide to date. Some of these gastric and esophageal submucosal hematomas were caused by pancreatitis, peptic ulcers, spontaneous hematomas, and endoscopic therapy, and there are few reports of gastric or esophageal submucosal hematomas related to vascular malformations.

We present the case of a 57-year-old male who had repeated episodes of nausea and vomiting for 2 days. Physical examination was unremarkable. Complete blood count revealed moderate anemia and elevated inflammatory markers. A gastroscopy revealed esophageal stricture 40 centimeter from the incisors. Computed tomography showed mixed high-density mass opacity extending from the esophagus to the lesser curvature of the stomach suggestive of esophageal and gastric submucosal hematomas. On contrast-enhanced scanning, a vascular malformation was seen in the left gastric artery. Active hemorrhage in the hematoma area was also observed. Vascular embolization of the malformed arteries was performed first, followed by conservative treatment of the hematomas. The patient's symptoms were relieved and the hematomas were reduced.

A ruptured vascular malformation represents an unusual cause of esophageal and gastric submucosal hematomas, conservative treatment following interventional therapy is an effective treatment option.