title: Intramural hematoma of the esophagus after thrombolysis for ischemic stroke.
abstract: Intramural dissecting hematoma is an unusual esophageal condition with a threatening presentation but excellent prognosis when managed conservatively.We report the case of an 88-year-old woman who developed an intramural hematoma of the esophagus after intravenous thrombolysis for an acute ischemic stroke. Before thrombolysis, nasogastric intubation was attempted unsuccessfully. She was kept on nil by mouth, intravenous hydration, proton pump inhibitor, antiemetics,and an antibiotic initiated 2 days before for periodontal disease. The esophageal hematoma regressed, and she resumed oral diet asymptomatically.To our knowledge, this is the first report of this type of lesion after thrombolysis for an ischemic stroke. A brief discussion and literature review are presented.
authors.affiliation: Gastroenterology Department, Central Lisbon Hospital Centre, Alameda de Santo António dos Capuchos, 1169-050, Lisboa, Portugal; NOVA Medical School, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal. Electronic address: mariojorgesilva01@gmail.com.
authors.forename: Mario Jorge
authors.initials: MJ
authors.lastname: Silva
authors.affiliation: Gastroenterology Department, Central Lisbon Hospital Centre, Alameda de Santo António dos Capuchos, 1169-050, Lisboa, Portugal; NOVA Medical School, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Saiote
authors.affiliation: Internal Medicine Department 1.2, Central Lisbon Hospital Centre, Rua José António Serrano, 1150-199, Lisboa, Portugal.
authors.forename: Vera
authors.initials: V
authors.lastname: Salvado
authors.affiliation: Stroke Unit, Central Lisbon Hospital Centre, Rua José António Serrano, 1150-199, Lisboa, Portugal.
authors.forename: Ana Paiva
authors.initials: AP
authors.lastname: Nunes
authors.affiliation: Gastroenterology Department, Central Lisbon Hospital Centre, Alameda de Santo António dos Capuchos, 1169-050, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Duarte
mesh_terms: D000369:Aged, 80 and over; D004935:Esophageal Diseases / Q000139:chemically induced*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006406:Hematoma / Q000139:chemically induced*; D006801:Humans; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator