Agustos 2016

57-58

Şehmus ÖLMEZ¹, Ufuk AVCIOĞLU², Bünyamin SARITA޳, İlyas TENLİK⁴

1Department of Gastroenterology, Adana Numune Research and Training Hospital, Adana, Turkey
²Department of Gastroenterology, Koru Hospital, Ankara, Turkey
³Department of Gastroenterology, Elazıg Medical Park Hospital, Elazığ, Turkey
⁴Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey

Özofagus intramural hematomu nadir görülen ve benign seyirli bir klinik durumdur. En sık görülen semptomlar göğüs ağrısı (%84), odinofaji veya disfaji (%59) ve hematemezdir (%56). Balık kılçığına bağlı özofagus hematomu nadir bildirilmiştir. Brada balık kılçığına bağlı oldukça nadir görülen bir vakayı sunacağız.

Balık kılçığı, intramural hematom, özofagu

Intramural hematoma of the esophagus (IHE) is a rare and benign clinical entity. The most common symptoms of IHE are chest pain (84%), odynophagia or dysphagia (59%), and hematemesis (56%) (1, 2). There are a few reports of intramural esophageal hematoma caused by fish bone ingestion (3, 4), and herein, we also report a very rare case of IHE caused by fish bone ingestion.

Depending on its etiology, IHE is classified into idiopathic and traumatic types. The traumatic type is caused by a direct wound in the esophagus by a foreign object or other trauma such as external injuries, cardiac massage, or endoscopic injection sclerotherapy (1). Most ingested foreign bodies can pass through the gastrointestinal tract spontaneously (5). IHE can also be caused by eosinophilic esophagitis (6). We believe that in our case, the hematoma was a result of a traumatic condition related to fish bone ingestion, as there was no other condition causing a hematoma. In conclusion, IHE is a rare disorder with different etiologies. However, our case shows that an IHE can occur due to ingestion of a foreign body such as a fish bone.

Depending on its etiology, IHE is classified into idiopathic and traumatic types. The traumatic type is caused by a direct wound in the esophagus by a foreign object or other trauma such as external injuries, cardiac massage, or endoscopic injection sclerotherapy (1). Most ingested foreign bodies can pass through the gastrointestinal tract spontaneously (5). IHE can also be caused by eosinophilic esophagitis (6). We believe that in our case, the hematoma was a result of a traumatic condition related to fish bone ingestion, as there was no other condition causing a hematoma. In conclusion, IHE is a rare disorder with different etiologies. However, our case shows that an IHE can occur due to ingestion of a foreign body such as a fish bone.

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3. Koike J, Matsushima M, Teraoka H et al. A case of submucosal hematoma of the esophagus and stomach, possibly caused by fish bone ingestion. Tokai J Exp Clin Med 2010;35:46-56
 4. Chen YY, Yen HH, Yao CD et al. Dysphagia following fish bone ingestion. Gut 2007;56:814.
5. McCanse DE, Kurchin A, Hinshaw JR. Gastrointestinal foreign bodies. Am J Surg 1981;142:335-7.
6. Sgrò A, Betalli P, Battaglia G et al. An unusual complication of eosinophilic esophagitis in an adolescent: intramural esophageal dissection. Endoscopy 2012;44:19-20.