"Spontaneous Intramural Esophageal Hematoma Associated with Uncontrolled Hypertension: Case Report and Review"

Intramural esophageal hematoma (IEH) is a rare entity in the spectrum of esophageal injuries that often present with symptoms, such as acute chest pain, dysphagia and/or hematemesis. Herein, we present an interesting case of spontaneous IEH in a patient with uncontrolled hypertension, in the absence of established predisposing factors.

61-years female, with a history of hypertension but no coagulopathy or anticoagulant/antiplatelet use, presented with sudden onset chest pain associated with complete dysphagia for 6 hours. She was found to have uncontrolled hypertension, with a blood pressure of 220/110 mmHg. She underwent computed tomography imaging of the chest followed by upper gastrointestinal endoscopy, which confirmed a diagnosis of spontaneous IEH. Conservative management and aggressive blood pressure control led to complete resolution of IEH within four weeks.

This case highlights the importance of considering spontaneous IEH in the differential diagnosis of acute-onset chest pain with dysphagia in hypertensive patients, particularly in those with atypical presentations.