硬化療法後に食道粘膜下血腫を生じ気管切開を要した食道静脈瘤の1例

DOI
  • 今村 潤
    がん･感染症センター都立駒込病院／肝臓内科
  • 木村 公則
    がん･感染症センター都立駒込病院／肝臓内科
  • 佐伯 俊一
    がん･感染症センター都立駒込病院／肝臓内科
  • 林 星舟
    がん･感染症センター都立駒込病院／肝臓内科

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タイトル別名
  • A case of submucosal hematoma of the esophagus after endoscopic injection sclerotherapy for esophageal varices

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A 60-year-old woman with hepatitis C virus-related liver cirrhosis was admitted to our institute for treatment of recurrent esophageal varices. After endoscopic injection sclerotherapy (EIS) using 1% polidocanol, the patient complained of chest pain, aphagia and dyspnea. At POD 3, upper gastrointestinal endoscopy and computed tomography showed a large submucosal hematoma of the esophagus. The lumen of the esophagus was occluded by the hematoma, which extended proximally to the larynx. Laryngeal endoscopy revealed that the hematoma also resulted in marked swelling of the epiglottis. Tracheotomy was performed as emergency airway management. At POD 6, the hematoma extended to the pharynx and a subcutaneous hematoma was observed in the cervical region. From POD 9 onward, the hematoma reduced in size, and the patient recovered gradually with no aftereffects. Submucosal hematoma of the esophagus should be considered as a potential major complication of EIS.

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