Document Detail

Intramural esophageal hematoma after elective injection sclerotherapy.
MedLine Citation:
PMID:  20232006     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Although endoscopic esophageal variceal sclerotherapy has been largely supplanted by variceal band ligation, it is still performed routinely in many institutions, especially in developing countries. Intramural esophageal hematoma has been described as a rare complication of sclerotherapy. Risk factors have not been completely established. OBJECTIVE: To demonstrate the incidence of post-sclerotherapy intramural esophageal hematoma in our hospital and discuss the possible factors involved. METHODS: This is a retrospective observational study made at the 'Hospital Universitário Clementino Fraga Filho', Rio de Janeiro, RJ, Brazil, reviewing the medical records of all esophageal variceal sclerotherapy procedures performed from April 2000 to November 2005. The evaluation of the clinical, laboratorial and endoscopic features in our patients and those reported in the literature was also done. Review of literature was performed through MEDLINE search. RESULTS: A total of 1,433 esophageal variceal sclerotherapy procedures were performed in 397 patients, with an intramural esophageal hematoma incidence of 4 cases (0.28%). Three of our patients developed additional complications, and one death was a direct consequence of a rupture of the hematoma. Nineteen well described cases were reported in the literature. Intramural esophageal hematoma occurred mostly after the forth esophageal variceal sclerotherapy session. Coagulation disturbances were present in the majority of cases. CONCLUSION: Intramural esophageal hematoma is a rare complication of esophageal variceal sclerotherapy and its incidence in our institution was similar to those observed in the literature. Our study suggests that this complication occurs as a result of a fragile esophageal mucosa after previous esophageal variceal sclerotherapy sessions. Impaired coagulation, although not essential, could contribute to hematoma formation and extension through esophageal submucosa.
Hannah Pitanga Lukashok; Carlos Robles-Medranda; Marília de Andrade Santana; Marcia Henriques Magalhães Costa; Adriana de Almeida Borges; Cyrla Zaltmani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arquivos de gastroenterologia     Volume:  46     ISSN:  1678-4219     ISO Abbreviation:  Arq Gastroenterol     Publication Date:    2009 Oct-Dec
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15310600R     Medline TA:  Arq Gastroenterol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  279-83     Citation Subset:  IM    
Gastroenterology Division, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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MeSH Terms
Esophageal Diseases / etiology*
Esophageal and Gastric Varices / therapy*
Hematoma / etiology*
Middle Aged
Retrospective Studies
Sclerotherapy / adverse effects*,  methods

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