Nayak HK, Krishna VP, Mohindra S, Saraswat VA, Mohindra N, Pande G.
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Abstract

A 30-year-old woman with chronic calcific pancreatitis who underwent extracorporeal shockwave lithotripsy (5,000 8-kV shockwaves) subsequently had one episode of mild hematemesis. Esophagogastroduodenoscopy revealed a large (9 × 7 cm) submucosal hematoma along the anterior wall of the stomach at the distal body and antrum. Contrast-enhanced computed tomography revealed submucosal hyperdensity of the gastric wall at the distal body and antrum suggestive of submucosal hemorrhage and bilateral renal subcapsular haemorrhage. The patient was managed conservatively. There was no further bleeding, and the gastric hematoma resolved in follow-up over the subsequent 4 months. Submucosal hematoma of the stomach is rare and can result from endoscopic therapy, coagulopathy, trauma, anticoagulation therapy, or repeated vomiting. This was a rare case of a large gastric submucosal hematoma due to extracorporeal shockwave lithotripsy that was successfully managed with conservative therapy.

Am J Gastroenterol. 2016 Dec;111(12):1679. doi: 10.1038/ajg.2016.319.