Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report
Abstract Background Esophageal submucosal hematoma is a rare complication after endovascular surgery. We report a case of an esophageal submucosal hematoma which may have been caused by rigorous cough during extubation. Case presentation A 75-year-old woman underwent endovascular treatment for unrup...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SpringerOpen
2017-10-01
|
Series: | JA Clinical Reports |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s40981-017-0124-3 |
id |
doaj-35f18676e8114ab8bfd1ec734238fca1 |
---|---|
record_format |
Article |
spelling |
doaj-35f18676e8114ab8bfd1ec734238fca12021-03-02T08:21:57ZengSpringerOpenJA Clinical Reports2363-90242017-10-01311510.1186/s40981-017-0124-3Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case reportSachiko Ito0Shihoko Iwata1Izumi Kondo2Motoyo Iwade3Makoto Ozaki4Tatsuya Ishikawa5Takakazu Kawamata6Department of Anesthesiology, Tokyo Women’s Medical UniversityDepartment of Anesthesiology, Tokyo Women’s Medical UniversityDepartment of Anesthesiology, Tokyo Women’s Medical UniversityDepartment of Anesthesiology, Tokyo Women’s Medical UniversityDepartment of Anesthesiology, Tokyo Women’s Medical UniversityDepartment of Neurosurgery, Tokyo Women’s Medical UniversityDepartment of Neurosurgery, Tokyo Women’s Medical UniversityAbstract Background Esophageal submucosal hematoma is a rare complication after endovascular surgery. We report a case of an esophageal submucosal hematoma which may have been caused by rigorous cough during extubation. Case presentation A 75-year-old woman underwent endovascular treatment for unruptured cerebral aneurysm under general anesthesia. The patient received aspirin and clopidogrel before surgery and heparin during surgery. Activated clotting time was 316 s at the end of surgery. Protamine was not administered and continuous infusion of argatroban was started after surgery. She had a rigorous cough during removal of the tracheal tube and reported retrosternal discomfort postoperatively. She developed hemorrhagic shock after massive hematemesis. A diagnosis of esophageal submucosal hematoma was made by endoscopic examination and computed tomography. Hemostasis was achieved by compression with a Sengstaken-Blakemore tube and endoscopic cauterization. Blood pressure was recovered by blood transfusion. Endoscopic examination performed 7 days after surgery showed that esophageal submucosal hematoma had almost disappeared and slough had adhered to the mucosal laceration. The patient showed good recovery and was discharged 21 days after surgery. Conclusions Careful extubation and postoperative observation are required in patients receiving antiplatelet and anticoagulant therapy.http://link.springer.com/article/10.1186/s40981-017-0124-3Esophageal submucosal hematomaCoil embolizationCerebral aneurysmAntiplatelet and anticoagulant therapiesCough during tracheal extubation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sachiko Ito Shihoko Iwata Izumi Kondo Motoyo Iwade Makoto Ozaki Tatsuya Ishikawa Takakazu Kawamata |
spellingShingle |
Sachiko Ito Shihoko Iwata Izumi Kondo Motoyo Iwade Makoto Ozaki Tatsuya Ishikawa Takakazu Kawamata Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report JA Clinical Reports Esophageal submucosal hematoma Coil embolization Cerebral aneurysm Antiplatelet and anticoagulant therapies Cough during tracheal extubation |
author_facet |
Sachiko Ito Shihoko Iwata Izumi Kondo Motoyo Iwade Makoto Ozaki Tatsuya Ishikawa Takakazu Kawamata |
author_sort |
Sachiko Ito |
title |
Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report |
title_short |
Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report |
title_full |
Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report |
title_fullStr |
Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report |
title_full_unstemmed |
Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report |
title_sort |
esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report |
publisher |
SpringerOpen |
series |
JA Clinical Reports |
issn |
2363-9024 |
publishDate |
2017-10-01 |
description |
Abstract Background Esophageal submucosal hematoma is a rare complication after endovascular surgery. We report a case of an esophageal submucosal hematoma which may have been caused by rigorous cough during extubation. Case presentation A 75-year-old woman underwent endovascular treatment for unruptured cerebral aneurysm under general anesthesia. The patient received aspirin and clopidogrel before surgery and heparin during surgery. Activated clotting time was 316 s at the end of surgery. Protamine was not administered and continuous infusion of argatroban was started after surgery. She had a rigorous cough during removal of the tracheal tube and reported retrosternal discomfort postoperatively. She developed hemorrhagic shock after massive hematemesis. A diagnosis of esophageal submucosal hematoma was made by endoscopic examination and computed tomography. Hemostasis was achieved by compression with a Sengstaken-Blakemore tube and endoscopic cauterization. Blood pressure was recovered by blood transfusion. Endoscopic examination performed 7 days after surgery showed that esophageal submucosal hematoma had almost disappeared and slough had adhered to the mucosal laceration. The patient showed good recovery and was discharged 21 days after surgery. Conclusions Careful extubation and postoperative observation are required in patients receiving antiplatelet and anticoagulant therapy. |
topic |
Esophageal submucosal hematoma Coil embolization Cerebral aneurysm Antiplatelet and anticoagulant therapies Cough during tracheal extubation |
url |
http://link.springer.com/article/10.1186/s40981-017-0124-3 |
work_keys_str_mv |
AT sachikoito esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport AT shihokoiwata esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport AT izumikondo esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport AT motoyoiwade esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport AT makotoozaki esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport AT tatsuyaishikawa esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport AT takakazukawamata esophagealsubmucosalhematomadevelopedafterendovascularsurgeryforunrupturedcerebralaneurysmundergeneralanesthesiaacasereport |
_version_ |
1724240603476131840 |