Gastric intramural hematoma: a case report and literature review

Abstract

Intramural hematoma of the gastrointestinal tract is an uncommon occurrence, with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been described most commonly in association with coagulopathy, peptic ulcer disease, trauma, and amyloid-associated microaneurysms. A case of massive gastric intramural hematoma, secondary to anticoagulation therapy, and a gastric ulcer that was successfully managed with conservative therapy, is presented. A literature review of previously reported cases of gastric hematoma is also provided.

Figure 1)

Gastric endoscopy showing a large intramural mass (double-headed black arrow) on the posterior-inferior wall of the stomach near the fundus. The three single-headed black arrows identify different views of the 5 mm shallow ulcer overlying the top of the intramural mass

Figure 2)

Cross-sectional (A) and longitudinal (B) computed tomography scan with intravenous contrast images of the abdomen showing a well-defined homogeneous mass involving the inferior-posterior portion of the stomach (double-headed black arrow). Note that the mass is not communicating directly with the aorta and that it is significantly superior to the site of endovascular graft