Spontaneous gastric hematoma as a rare cause of acute abdomen: A case report.

Autor:	Budimir I; Department for Plastic and Reconstructive Surgery, University Hospital Dubrava, Zagreb 10000, Croatia.; Zagreb School of Medicine, University of Zagreb, Zagreb 10000, Croatia.; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia. ivan.budimir.marat@gmail.com., Žulec M; Department of Nursing, Catholic University of Croatia, Zagreb 10000, Croatia., Eljuga K; Department of Nursing, Bjelovar University of Applied Sciences, Bjelovar 43000, Croatia., Židak M; Department of Surgery, University of Zagreb, Dubrava University Hospital, Zagreb 10000, Croatia., Lisek V; Department of Abdominal Surgery, University Hospital Dubrava, Zagreb 10000, Croatia.; Doctoral Study of Biomolecular Sciences, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
Jazyk:	angličtina
Zdroj:	World journal of clinical cases [World J Clin Cases] 2023 Dec 26; Vol. 11 (36), pp. 8551-8556.
DOI:	10.12998/wjcc.v11.i36.8551
Abstrakt:	Background: Spontaneous gastric hematoma is an exceedingly rare condition characterized by the accumulation of blood within the gastric wall without any apparent iatrogenic or traumatic cause. Coagulopathies are the most frequent cause of gastric hematomas. However, other causes include amyloidosis, pancreatitis, visceral vascular aneurysms, endoscopy complications and others. The pathophysiology of spontaneous gastric hematoma is not completely understood. However, it is postulated that it is caused by disruption of submucosal vessels that leads to dissection of the muscularis layer and formation of false lumen. The rarity of this condition increases the challenge of diagnosis, and there is no standard treatment protocol. Case Summary: We present the case of a spontaneous gastric hematoma in a 22-year-old male. He presented to our emergency department complaining of pain in the left flank area lasting for 2 wk. There was no history of trauma, anticoagulant medications or endoscopy procedures. His hemoglobin and hematocrit levels were slightly lower than normal. Multi-slice computed tomography, ultrasound and endoscopy confirmed a gastric intramural hematoma. We recommended conservative treatment because there was no hemodynamic instability nor significant bleeding. The patient responded well, and there were no unexpected events. At the 3-mo follow-up, the ultrasound examination revealed complete regression of the hematoma. Conclusion: After reviewing the literature and our experience, we recommend that more of these cases should be treated conservatively. The tendency to treat these cases with potentially burdensome procedures such as total or subtotal gastrectomy should be significantly reduced. Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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