Extramural hematoma after esophageal stricture dilatation in mixed connective tissue disease

Excerpt

A 32-year-old lady, diagnosed with mixed connective tissue disease (MCTD) for six years, responded well to balloon dilatation (till 15 mm) for short peptic stricture three years back. At present, she came with dysphagia to solids. The short stricture with a smooth surface (Fig. 1a) was initially dilated with a controlled radial expansion (CRE) balloon dilator up to 10 mm. Two hours after her second session (till 12 mm CRE), she had a massive bout of hematemesis. An active bleed at the site of stricture, along with a hematoma, was noted (Fig. 1b). The bleeding site was identified and controlled using two hemoclips with local site adrenaline injection (Fig. 1c). Computerized tomography (CT) showed a large extramural hematoma with dilatation of esophageal lumen (Fig. 1d). She was discharged after three days with no recurrence of bleeding.

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