Large oesophageal haematoma as a result of transoesophageal echocardiogram (TEE)

Description

This is a 68-year-old man with known type A aortic dissection, post ascending aorta repair and mechanical aortic valve who presented with symptomatic severe mitral regurgitation secondary to a degenerative valve. Due to prohibitive surgical risk, the patient underwent transcatheter mitral clip placement under the guidance of transoesophageal echocardiogram (TEE). Post procedure the patient developed haematemesis and dysphagia to solid food. The patient underwent fluoroscopy, which showed oesophageal stricture (figure 1). The next morning labs showed a significant drop in haemoglobin to 6.9 g/dL requiring 1 unit of packed red blood cells. Contrast-enhanced CT scan of chest and abdomen was then performed, which showed large submucosal oesophageal 22 cm x 3.2 cm x 3.8 cm haematoma (figures 2 and 3). Haematoma extended along the entire length of the oesophagus and was severely compromising the oesophageal lumen (figure 3). On admission the patient was...

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