A 69-year-old man with no history of chest trauma was admitted to our institution complaining of blunt and severe central chest pain of cataclysmic onset radiating to the back. His medical history was remarkable only for a chronic atrial fibrillation treated with warfarin and amiodarone. On arrival, his ECG showed atrial fibrillation at 120 bpm with no signs of myocardial ischemia. Laboratory e...

A 51-year-old man was admitted to our hospital with hematemesis after swallowing a chicken bone. An endoscopy was performed, which showed a large submucosal hematoma in the esophagus, which extended from 15cm down to the esophagogastric junction. The esophageal lumen was occupied by the hematoma. No active bleeding or foreign body was seen (●" Fig.1;●" Video 1). The findings on examination and ...

We report a case of a patient with a residual hematoma compressing the inferior vena cava after endovascular aneurysm repair (EVAR), which led to a pulmonary embolism (PE). A 65-year-old man underwent emergent EVAR for a ruptured aortic aneurysm in the right retroperitoneal region. He developed sudden chest pain at midnight of the fifth day after EVAR, and computed tomography demonstrated a mas...

Causes of colonic and recto-sigmoid hematomas are multifactorial. Patients can present with a combination of dropping hemoglobin, bowel obstruction and perforation. Computed tomography imaging can provide clues to a diagnosis of intramural hematoma. We present a case of rectal hematoma and a review of current management literature. A 72-year-old male on therapeutic anticoagulation for a pulmona...

Intramural esophageal hematoma is part of a spectrum of esophageal injuries. Vomiting and straining, endoscopic procedures and bleeding disorders are the most common predisposing factors. However, it can also be an unusual complication of anticoagulation and/or thrombolysis therapy. The most common symptoms are retrosternal chest pain, dysphagia and hematemesis. Computed tomography is the modal...

症例は67歳の男性．食道癌術後8ヵ月時点で右上葉肺尖部に腫瘤像を指摘された．腫瘤の画像診断は肺内血腫とされたが，診断時にCTで最大径5.0 cmであったのが49日後には8.3 cmに達し，悪性腫瘍が疑われた．病変は食道癌治療前のCTで右上葉に0.8 cm大の結節として描出されていたが，炎症性変化との診断であった．気道内出血を避けるため生検は行わず，右上葉切除を施行した．肺多形癌p-T2bN0M0 p-StageIIAと診断された．術後5年無再発を確認しフォローを終了した．肺多形癌は急速に増大する傾向が指摘されており，本症例のように画像診断が肺内血腫であっても比較的急速に増大する例では悪性腫瘍の潜在を疑い，早い段階で切除を決断すべきと考えられた．

Anticoagulant therapy may cause the onset of a spontaneous intramural hematoma of the small bowel, in the jejunum, ileum or duodenum. A 53-year-old woman on therapy with heparin for previous pulmonary embolism was admitted for abdominal pain and vomit. Computed tomography scan visualized an intramural hematoma of the jejunum causing subtotal obstruction of the intestinal lumen. The patient unde...