A case of submucosal hematoma of the esophagus noticed postoperatively

We experienced a case of submucosal hematoma of the esophagus noticed after cervical anterior spinal fusion (ASF) between C7 and T1 for ossification of posterior longitudinal ligament (OPLL). The patient was a 68-year-old man, and no abnormality was found in the preoperative examinations. Anesthesia was induced and maintained with remifentanil, propofol and vecuronium. Tracheal intubation was performed using fiberscope uneventfully, and gastric tube and esophageal stethoscope were inserted into the esophagus smoothly. The operation was completed in 7 hours and 10 minutes. When we removed the gastric tube and the esophageal stethoscope after the operation, no bloody secretion was noticed. The next day, the patient complained of melena, and gastrointestinal endoscopy showed a submucosal hematoma extending from the posterior wall of the cervicothoracic border in the esophagus to the cardia. Submucosal hematoma of the esophagus is a rare complication. In this case, surgical procedure was suspected to have caused the hematoma, since the upper end of the hematoma corresponded to the surgical field.