2023 年第 10 期 第 18 卷

自发性食管血肿并发消化道出血1例报道及文献复习

Spontaneous esophageal hematoma complicated with gastrointestinal bleeding: a case report and literature review

作者：朱相象李璠李睿杨永林王春艳曹亚琼陈嘉屿

英文作者：Zhu Xiangxiang Li Fan Li Rui Yang Yonglin Wang Chunyan Cao Yaqiong Chen Jiayu

单位：中国人民解放军联勤保障部队第九四〇医院消化内科，兰州730050

英文单位：Department of Gastroenterology the 940th Hospital of the Joint Service Support Force of the Chinese People′s Liberation Army Lanzhou 730050 China

关键词：食管血肿；消化道出血；文献复习

英文关键词：Esophagealhematoma;Gastrointestinalbleeding;Literaturereview

• 摘要：

• 本文通过阐述1例自发性食管血肿合并消化道出血患者的临床特征、诊治经过以及预后等特点，结合相关文献分析该病可能的诱发因素及相关发病机制。本例患者以进食哽噎、胸骨后疼痛、呕血为主要临床表现，结合心肌酶谱、肌红-肌钙蛋白、胸部CT、主动脉CT血管造影、胃镜检查等明确诊断为食管血肿，经内科保守治疗好转出院，随访期间患者无不适症状。此类疾病属于少见病，患者症状缺乏特异性，极易发生临床误诊、漏诊，进而延误治疗时机，因此临床医生需加强对该病的认识，从而早诊断、早治疗，降低病死率。

• By expounding the clinical characteristics, diagnosis, treatment and prognosis of a patient with spontaneous esophageal hematoma complicated with gastrointestinal bleeding, combined with the relevant literature, the possible inducing factors and related pathogenesis of the disease were analyzed. The main clinical manifestations of this patient were choking after eating, pain after sternum and hematemesis. Combined with myocardial zymogram, myoglobin troponin, chest CT and aortic CT angiography and gastroscopy, it was clearly diagnosed as esophageal hematoma. It was improved and discharged after conservative treatment. There were no discomfort symptoms in the follow-up. This kind of disease is rare. The symptoms of patients are lack of specificity, which is prone to clinical misdiagnosis and missed diagnosis, and then delay the treatment opportunity of patients. Therefore, clinicians need to strengthen the understanding of the disease, so as to make early diagnosis and treatment, alleviate the symptoms of patients and reduce the mortality.