• Bo Wu, Xincheng Xie, Xiao Li, Qun Zhu, and Chunhua Zhou.
• Department of Gastroenterology, HangZhou Xixi Hospital, Hangzhou, China.
• Medicine (Baltimore). 2023 Jan 27; 102 (4): e32752e32752.

RationaleEndoscopic injection sclerotherapy (EIS) is a common treatment for patients with liver cirrhosis and esophageal varices. It can effectively treat variceal rupture and bleeding caused by liver cirrhosis. However, EIS has many complications, including postoperative bleeding, retrosternal pain, esophageal ulcers, esophageal stenosis, and ectopic embolism. Intramural hematoma of the esophagus (IHE) is a rare complication of EIS that can lead to chest tightness, chest pain, and dysphagia.Patients ConcernsA 55-year-old man developed severe nausea and vomiting accompanied by chest pain after EIS.DiagnosisComprehensive imaging features, the patient was diagnosed as IHE.InterventionsA vascular clamp was used for hemostasia, and a feeding tube was placed in the patient's jejunum.OutcomesAfter the removal of the jejunal feeding tube and the intake of a semiliquid diet, the patient had no episodes of chest pain, chest tightness, or dysphagia and was discharged after 2 days of observation.LessonsAlthough IHE rarely occurs after EIS, we should not overlook its risk. The occurrence of IHE is not directly related to the number of EISs received or the degree of liver cirrhosis but is more likely related to postoperative nausea and vomiting. Therefore, timely medication and observation are particularly important for patients with nausea and vomiting after endoscopic treatment.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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