Acute aortic syndromes after esophageal endoscopic submucosal dissection

Endoscopic Submucosal Dissection (ESD) is established as a primary therapeutic approach for early esophageal cancer, with perforation, bleeding, and stricture recognized as the most significant complications. Current evidence regarding acute aortic syndromes (AAS) following ESD remains limited.

A previously healthy, 66-year-old woman presented with half a month history of early esophageal cancer through upper gastrointestinal endoscopy. Upper gastrointestinal endoscopy examination showed: Approximately 21-25 cm away from the incisors, a type II-b lesion on the left posterior wall of the esophagus. Eight days post-hospitalization, she underwent esophageal ESD. Seven hours post-operation, she experienced sudden chest pain. An urgent chest CT scan suggested aortic intramural hematoma(IMH). Following transfer to the vascular surgery department for symptomatic supportive treatment, her condition stabilized, leading to her discharge. Follow-up at three and six months confirmed the aortic condition remained stable. The occurrence of AAS post-ESD is exceedingly rare, with minimal reports in the published literature.

This study reviews the major complications associated with ESD and explores the potential link between esophageal ESD and AAS.