Transmural Hematoma in Anterior and Posterior Walls of Stomach Caused by Blunt Force Injury of the Abdomen

概要

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The subject was a 21-year-old male who fell from a motorcycle, and injured his epigastrium on the handlebar. He visited a doctor in his neighborhood, and was given blood tests, abdominal x-rays, and an abdominal CT. He was diagnosed with abdominal bruising and kept under observation. On the 2nd day after the injury, he started to experience tarry stools; on the 13th day, he started to experience dizziness particularly when he stood up. Therefore he visited our hospital. During the examination, he exhibited significant anemia. Gastroscopy revealed that there was a submucosal tumor in the anterior and posterior walls of stomach. In addition, in the mucous of the tumor, punctuate petechiae were observed. According to these results, the patient was diagnosed as having gastric intramural hematoma caused by blunt injury and anemia due to bleeding from the mucous rupture. Iron dosing gradually improved anemia, and further bleeding from the mucous rupture was prevented by fasting. With gastroscopy conducted on the 53rd day after the injury, the gastric hematoma was confirmed to have disappeared. Gastric intramural hematoma seems to require treatment for delayed complications. It is important to keep patients under observation anticipating that they might develop delayed complications. The details of the examination for this case are given for future reference.
一般社団法人日本救急医学会の論文