Submucosal esophageal abscess evolving into intramural submucosal dissection: A case report

Area of Science:

• Gastroenterology
• Endoscopy
• Esophageal Diseases

Background:

• Reports a rare case of an esophageal submucosal abscess.
• Documents its evolution into intramural submucosal dissection.

Observation:

• An 80-year-old woman presented with dysphagia and fever.
• Imaging revealed esophageal wall thickening; endoscopy showed a laceration and submucosal mass.
• Spontaneous drainage of purulent exudate occurred, treated with endoscopic clips and antibiotics.

Findings:

• The esophageal submucosal abscess resolved, but intramural esophageal dissection developed.
• Endoscopic incision of the septum using a dual-knife was performed effectively.

Implications:

• This is the first reported case of esophageal submucosal abscess evolving into intramural esophageal dissection.
• Highlights the importance of recognizing this progression.
• Suggests endoscopic incision as a routine therapeutic option for intramural esophageal dissection.