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Esophageal transection.

Beyza Özçınar1, Kıvanç Derya Peker1, Sertaç Demirel1

  • 1Department of General Surgery, Istanbul University Istanbul School of Medicine, Istanbul, Turkey.

Ulusal Cerrahi Dergisi
|February 3, 2017
PubMed
Summary

Intramural esophageal dissection, a rare condition, involves a tear in the esophagus without perforation. This case highlights its potential for complications, though conservative management is often successful.

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Area of Science:

  • Gastroenterology
  • Cardiology
  • Vascular Surgery

Background:

  • Intramural esophageal dissection (IED) is a rare condition characterized by a laceration between the esophageal mucosa and submucosa, without full-thickness perforation.
  • IED can present with symptoms such as chest pain, hematemesis, and odynophagia, mimicking other acute gastrointestinal or cardiac events.

Observation:

  • An 86-year-old female patient with an abdominal aortic aneurysm developed IED after aortic stent placement and heparinization.
  • Symptoms included retching, vomiting, sudden chest pain, hematemesis, back pain, and odynophagia.
  • Endoscopic visualization revealed a thoracic esophageal hematoma and a false lumen, but no perforation.

Findings:

  • The esophageal hematoma bled upon endoscopic intervention due to air insufflation.
Keywords:
Esophagusesophagus transectiontransection

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  • Despite the potential for bleeding and complications, the patient was managed conservatively.
  • The patient was discharged uneventfully, indicating successful conservative treatment for this rare condition.

    • Implications:

    • This case underscores that intramural esophageal dissection, often considered benign, carries a risk of perforation.
    • Conservative management appears to be a viable and effective approach for most cases of IED.
    • Further research into the predisposing factors and optimal management strategies for IED is warranted.