Gastric intramural hematoma subsequent to thoracic aortic di
Intramural hematomas of the gastrointestinal tract are uncommom, usually located in the esophagus or duodenum, with idiophatic or secondary causes. Published in the journal Annals of Surgery and Medicine, the authors present a very rare case of gastric intramural hematoma caused by an unpublished etiology, with literature review.

An elderly woman suffered acute thoracic aorta dissection followed by gastric intramural hematoma, diagnosed through endoscopy and computed tomography angiography. The treatment included endovascular aortic repair and conservative management.

Lessons learnt:-
• The postulated mechanism for the bleeding in gastric intramural hematoma is shredding of terminal arteries at the point of penetration into the muscular layer with subsequent dissection of the muscularis propria from the submucosa.

• The most frequently cited risk factor is hemorrhagic diathesis/anticoagulant use and the main etiologies are trauma and post-interventional endoscopy.

• In the diagnosis work-up, computed tomography is the method of choice, usually associated with endoscopy. There is no standard of care for such rare condition.

• Thus, treatment may be cause-dependent, ranging from conservative to minimally invasive and/or surgery.

Read about the case in detail here: