Title:Esophageal Hematoma Mimicking Esophageal Varices after Chewing Betel Nut:
A Case Report
Volume: 20
Author(s): Yan Shi, Qian-neng Wu*, Fu-long Zhang, Shu-rong Chen, Dan Zhou and Yuan-dong Zhu
Affiliation:
- Digestive Department, Hangzhou Xixi hospital, Zhejiang, China
Keywords:
Betel nut, Rare acute toxicity, Esophageal hematoma, Aspartate aminotransferase, Blood urea nitrogen, Serum creatinine.
Abstract:
Background:
Betel nut chewing is very common in Southeast Asia and other tropical countries. Much clinical evidence suggests that chewing betel nut has proinflammatory
and carcinogenic effects, but there are few clinical reports of acute toxicity caused by it, especially involving esophageal damage.
Case presentation:
We presented a case of a 72-year-old female who was admitted to our hospital for chest pain and hematemesis within several minutes after
chewing betel nut. Gastroscopy showed two longitudinal ridge-like mucosal eminences in the esophagus located 20 cm from the incisors down to
the gastric cardia, which was similar to varices. At last, a CT scan showed concentric-circle thickening of the esophagus wall, suggesting
hematomas. Our treatment included fasting, inhibiting gastric acid and maintaining blood volume. After one week of medical treatment, rechecked
gastroscopy showed that esophageal hematomas were gradually absorbed, with the formation of multiple shallow ulcers.
Conclusion:
The acute toxicity of chewing betel nut can be easily overlooked. Patients who experience chest pain or hematemesis after chewing betel nut
products,especially those who take aspirin at the same time, need to be alert to esophageal hematoma.
