A hematoma of the esophagus causing the trachea to stenose

We report a case of spontaneous intramural hematoma of the esophagus (SIHE) with severe dyspnea due to compression of the trachea. SIHE is a rare hematoma that commonly presents with chest pain, epigastralgia, hematemesis, and dysphagia. Dyspnea is not a common symptom; it has been reported in only one patient, who underwent surgery. In our case, intubation of the compressed trachea prevented it from becoming more stenosed, and an operation was not needed. Another unusual feature of this case is the endoscopic findings. Endoscopic examination in SIHE has often revealed the presence of a dark red, bluish, or purplish bulge, suggesting the presence of a clot or blood in the esophageal wall. In our case, the bulge revealed by endoscopy in the esophageal lumen was white at first, before later turning dark red.