{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:32:45Z","timestamp":1755225165380,"version":"3.43.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Esophageal submucosal hematoma is a rare, often incidental complication of therapeutic endoscopic procedures marked by disrupted blood vessels beneath the esophageal mucosa, forming a hematoma. We report the unique case of a severely thin and alcoholic 38\u2010year\u2010old woman with a history of reflux esophagitis who developed an esophageal submucosal hematoma during an unsedated transnasal endoscopy for health check\u2010up. During the procedure, the patient experienced strong vomiting reflexes and vomited blood, leading to the initial suspicion of either Mallory\u2010Weiss syndrome or epistaxis. However, subsequent sedated endoscopy revealed an esophageal submucosal tumor\u2010like lesion and a mucosal laceration with blood clots, prompting a dual diagnosis of esophageal submucosal hematoma and Mallory\u2010Weiss syndrome. The bleeding was not severe enough to require hemostatic intervention. The patient opted for conservative treatment with vonoprazan, which resulted in the improvement and healing of the hematoma within 28 days. This is the first report of an esophageal submucosal hematoma during transnasal endoscopy and emphasizes the importance of including an esophageal submucosal hematoma and Mallory\u2010Weiss syndrome in the differential diagnosis of hematemesis encountered in similar scenarios. Factors such as severe thinness, daily alcohol consumption, and reflux esophagitis may have possibly contributed to the development of the esophageal submucosal hematoma in this patient.<\/jats:p>","DOI":"10.1002\/deo2.366","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:49:41Z","timestamp":1713228581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Esophageal submucosal hematoma during transnasal endoscopy: A rare case report"],"prefix":"10.1002","volume":"4","author":[{"given":"Atsushi","family":"Kanamori","sequence":"first","affiliation":[{"name":"Department of Premier Preventive Medicine\/MedCity21 Osaka Metropolitan University Graduate School of Medicine  Osaka Japan"},{"name":"Department of Gastroenterology Osaka Metropolitan University Graduate School of Medicine  Osaka 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