Spontaneous intramural hematoma of stomach

Abstract

Background: Intramural hematoma occurs uncommonly in the gastrointestinal tract and very rarely in the stomach. In case of a spontaneous gastric hematoma, the few previously reported patients all had certain predisposing factors. However, truly spontaneous intramural hematoma of the stomach without an identifiable cause has not been reported before.

Method: Emergency total gastrectomy was performed in a 49-year-old man with such pathology and the diagnosis was made postoperatively.

Results: The patient required further laparotomy on day 10 for drainage and debridement of a subphrenic abscess. He recovered uneventfully from the second operation. After an extensive pathological search, no predisposing factors could be found. The patient remains in good health 18 months after the operations.

Conclusion: Spontaneous intramural gastric hematoma is extremely rare. But even rarer is when predisposing conditions or lesions are absent.