Unusual Mucosal Protrusion Along with Ulceration in the Esophagus

Special Article - Cancer Clinical Cases and Images

Austin J Clin Case Rep. 2015; 2(4): 1082.

Unusual Mucosal Protrusion Along with Ulceration in the Esophagus

Dianbo Cao*

Department of Radiology, The First Hospital of Jilin University, China

*Corresponding author: Dianbo Cao, Department of Radiology, The First Hospital of Jilin University, China

Received: October 13, 2015; Accepted: November 04, 2015; Published: November 06, 2015

Keywords

Aortoesophageal fistula; Aortic Pseudoaneurysm; Endoscopy; CT; Treatment

Clinical Image

An 11-year-old boy presented with mid-upper retrosternal and abdominal pain for 5 days with haematemesis twice during the abdominal pain. There was around 600-700ml of haematemesis and the blood was dark in color. Prior to the day of admission, he had an episode of black stool. There was no significant past medical history. On physical examination, he looked pale. There was tenderness over right lower abdomen without rebound tenderness. His laboratory reports showed WBC as 11.3×109/L with 76% of neutrophil and hemoglobin as 86g/L. Taking into consideration of haematemesis and melena as a predominant complaint on this consultation, following endoscopy revealed mucosal bulge of 2.2cm×5cm with ulceration at the centre of bulging mass together with blood clot at 22-25cm distance from incision (Figure 1) and stomach was normal. Non-enhanced and contrast-enhanced CT scan was required to clarify esophageal mass, which revealed proximal descending aortic Pseudoaneurysm due to esophageal foreign body (FB) (Figure 2,3). Immediately, the patient underwent aortic reconstruction after removing aortic Pseudoaneurysm and esophageal perforation repair under general anesthesia. FB identified by CT is an alloying metal which is used to clean the utensils, which was engulfed unnoticingly when he recalled a past history of eating hot spicy dips. The post-operative course was uneventful, and he was free of pain and haematemesis on the followup of 12 months.