Open AccessSpontaneous intramural esophageal dissection preceded by intramural esophageal hematoma: Report of a case study
Author(s) -
Wang ChihHsien,
Tseng PingHuei,
Lee YiChia,
Wu MingShiang,
Wang HsiuPo,
Chen ChienChuan
Publication year - 2019
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1002/aid2.13106
Subject(s) - odynophagia , medicine , dysphagia , chest pain , radiology , surgery , hematoma , endoscopy , dissection (medical)
Spontaneous intramural esophageal dissection (IED) is a rare disorder characterized by acute symptoms, including chest pain, odynophagia, dysphagia, or hematemesis and remarkable endoscopic or radiographic findings. The pathophysiology is complex and remains poorly understood. Here, we report a 63‐year‐old woman who presented with progressive odynophagia, dysphagia, and weight loss. We diagnosed spontaneous IED with false lumen formation extending to the stomach using ultra‐thin upper endoscopy and water‐soluble contrast esophagogram. Comparing the patient's chronological computed tomographic images before and after symptom onset, we found that spontaneous IED was preceded by an intramural esophageal hematoma. Her symptoms persisted after 3 weeks of conservative treatment. Therefore, combined modalities of endoscopic transection and tissue glue application were given, and her symptoms improved gradually.