経皮的冠動脈インターベンションの合併症としての食道内血腫：症例報告

BACKGROUND Intramural esophageal hematoma (IEH) is a rare disease characterized by clinical manifestations such as chest pain, hematemesis, dysphagia, or odynophagia. Patients who have undergone coronary stent implantation often have several high-risk factors that can predispose them to IEH. Therefore, special attention should be paid to the etiology of chest pain after percutaneous coronary intervention (PCI). CASE REPORT We report the case of a 67-year-old man who presented with acute chest pain after PCI. He had stents implanted in the left circumflex artery and the right coronary artery in 2019, followed by another stent placed in the right coronary artery in 2022. He was readmitted due to chest pain and underwent coronary angiography, during which a stent was placed in the left anterior descending artery. He developed chest pain within 24 hours after PCI, which was subsequently accompanied by nausea, vomiting, diaphoresis, and hiccups. An electrocardiogram showed no dynamic changes, and cardiac injury biomarkers were negative. Chest computed tomography (CT) was later performed, raising suspicion of intramural esophageal hematoma, which was ultimately confirmed by gastroscopy. The patient recovered and was discharged after pharmacological treatment. CONCLUSIONS Post-PCI chest pain can indicate complications such as coronary artery occlusion or pericardial effusion. This case demonstrates that IEH can also occur after PCI. As patients receiving stents require antithrombotic therapy, their risk is elevated, underscoring the importance of early diagnosis and management.