eMedicine Specialties > Gastroenterology > Esophagus

Esophageal Hematoma: Follow-up

Author: Jennifer Lynn Bonheur, MD, Fellow, Department of Internal Medicine, Division of Gastroenterology, Lenox Hill Hospital
Coauthor(s): Klaus Radebold, MD, PhD, Research Associate, Department of Surgery, Yale University School of Medicine
Contributor Information and Disclosures

Updated: Jul 20, 2006

Follow-up

Further Inpatient Care

  • Follow-up care after the acute event has resolved with either a barium swallow or endoscopy is necessary to rule out any additional esophageal disease not seen on the initial evaluation. This can be done prior to discharge or can be arranged to be done on an outpatient basis.

Complications

  • Full-thickness perforations of the esophageal wall have been reported during endoscopy of an esophageal hematoma.

Prognosis

  • Long-term results are very good with conservative and supportive treatment.
  • Intermittent odynophagia usually subsides within 2 weeks after the primary event.
  • Recurrence is extremely rare.

Miscellaneous

Medicolegal Pitfalls

  • Distinguishing esophageal hematoma from cardiac ischemia or pulmonary embolism is critical because esophageal hematoma can be worsened by thrombolysis and anticoagulation.
  • In contrast to an intramural esophageal hematoma, an aortoesophageal fistula is a life-threatening condition that may present as a submucosal esophageal hematoma. On endoscopy, an aortoesophageal fistula is noted as a pulsatile esophageal mass. The prognosis is grave if surgical intervention is delayed.
  • Filling defects on the esophagogram have been confused with tumors. Conversely, a follow-up endoscopy or barium swallow should be performed to ensure that a tumor or other esophageal pathology was not missed on the initial evaluation.
  • Aortic dissection is a surgical emergency that must also be distinguished from esophageal hematoma in the initial evaluation.
  • Monitor for the development of a fever or pleural effusions, which may indicate an esophageal perforation missed during the initial evaluation.
 


More on Esophageal Hematoma

Overview: Esophageal Hematoma
Differential Diagnoses & Workup: Esophageal Hematoma
Treatment & Medication: Esophageal Hematoma
Follow-up: Esophageal Hematoma
References
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References

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Further Reading

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Keywords

esophageal apoplexy, esophageal mucosal tears, Mallory-Weiss syndrome, transmural perforation, Boerhaave syndrome, intramural hematoma of the esophagus, esophageal perforation, mediastinitis, abscess formation, vomiting, dysphagia, odynophagia, hematemesis, severe acute chest pain

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Contributor Information and Disclosures

Author

Jennifer Lynn Bonheur, MD, Fellow, Department of Internal Medicine, Division of Gastroenterology, Lenox Hill Hospital
Jennifer Lynn Bonheur, MD is a member of the following medical societies: American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, New York Academy of Sciences, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

Klaus Radebold, MD, PhD, Research Associate, Department of Surgery, Yale University School of Medicine
Klaus Radebold, MD, PhD is a member of the following medical societies: American Gastroenterological Association and New York Academy of Sciences
Disclosure: Nothing to disclose.

Medical Editor

Maurice A Cerulli, MD, FACG, Chief, Division of Gastroenterology and Hepatology, Associate Professor of Clinical Medicine, Department of Internal Medicine, Division of Gastroenterology, New York Methodist Hospital, Cornell University
Maurice A Cerulli, MD, FACG is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Medical Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Simmy Bank, MD, Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Assistant Dean for Medical Curriculum, Associate Professor of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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