Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Case Report

Volume 10, Number 2, February 2018, pages 154-157

Successful Treatment of Rapidly Progressive Life-Threatening Esophageal Submucosal Hematoma in a Patient With van der Hoeve Syndrome

Figure

Figure 1.
Figure 1. Clinical course. Hematemesis continued after admission and a massive esophageal submucosal hematoma was found during upper gastrointestinal endoscopy and computed tomography (CT) on day 4. Anemia and thrombocytopenia also progressed, and transfusions of RBC, PC, and FFP were administered. After the transfusions, the submucosal hematoma was rapidly absorbed. RBC: red blood cell transfusion, 2 units; PC: platelet concentrate, 10 units; FFP: fresh frozen plasma, 2 units.

Table

Table 1. Laboratory Data on Admission
 
Complete blood count  ALT85 IU/L
  WBC22,390/µL  LDH647 IU/L
    Stab1.0%  ALP520 IU/L
    Seg90.5%  γ-GTP266 IU/L
    Lymp6.0%  CK263 IU/L
    Mono2.0%  Na145 mEq/L
    Eosino0.0%  K5.9 mEq/L
    Baso0.5%  Cl95 mEq/L
  RBC366 × 104/µL  Ca9.1 mg/dL
  Hb12.6 g/dL  P10.8 mg/dL
  Ht38.5%  CRP0.08 mg/dL
  MCV105 fL  TG247 mg/dL
  MCH34.4 pg  T-Chol185 mg/dL
  MCHC32.7%  HDL74 mg/dL
  Plt17.4 × 104/µL  LDL52 mg/dL
  Reticulocyte22‰  Plasma glucose46 mg/dL
Biochemistry  HbA1c4.7%
  TP8.1 g/dLCoagulation parameters
  Alb4.7 g/dL  PT13.0 s (normal: 9.4 - 12.5)
  BUN23.2 mg/dL  PT-INR1.11 (normal: 0.85 - 1.15)
  Cre1.65 mg/dL  APTT33.1 s (normal: 25.1 - 36.5)
  UA11.1 mg/dL  Fbg212 mg/dL (normal: 276 - 471)
  T-Bil1.4 mg/dL  D-dimer2.66 µg/mL (normal: < 1.0)
  D-Bil0.7 mg/dL  Antithrombin-III80% (normal: 83-128%)
  AST388 IU/L  Hepaplastin test96% (normal: 70-120%)