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Spontaneous haematoma of the oesophagus is a rare cause of chest pain. We report the case of a 63-year-old female in whom spontaneous rupture of the oesophagus was suspected, but who was subsequently, found to have a dissecting intramural haematoma of the oesophagus. She successfully underwent mediastinal and thoracic drainage by right video-assisted thoracoscopy. Although conservative treatment is widely described in the literature, surgical treatment by right video-associated thoracoscopy may be a suitable alternative if there is a diagnostic doubt.

Is there a place for video-associated thoracoscopy for dissecting intramural haematoma of the oesophagus?