A Case of Conservatively Resolved Intramural Esophageal Dissection Combined with Pneumomediastinum.
10.4166/kjg.2012.60.4.249
- Author:
In Hye CHA
1
;
Jin Nam KIM
;
Sun Ok KWON
;
Sun Young KIM
;
Myoung Ki OH
;
Soo Hyung RYU
;
You Sun KIM
;
Jeong Seop MOON
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. nammi39@freechal.com
- Publication Type:Case Reports ; English Abstract
- Keywords:
Intramural esophageal dissection;
Mediastinal emphysema;
Conservative management
- MeSH:
Anti-Bacterial Agents/therapeutic use;
Esophageal Diseases/complications/*diagnosis/drug therapy;
Gastroscopy;
Hematemesis/complications/diagnosis;
Humans;
Male;
Mediastinal Emphysema/complications/*diagnosis/drug therapy;
Middle Aged;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2012;60(4):249-252
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Intramural esophageal dissection (IED) is a rare form of esophageal injury. We report a rare case of spontaneous IED complicated with pneumomediastinum and successfully improved by conservative management. A 46-year-old man presented to the emergency department with chest pain and hematemesis. The endoscopic diagnosis was suspicious of IED. Chest CT scan performed to rule out complication noted IED combined with pneumomediastinum. He was managed conservatively with nil per oral, intravenous antibiotics and parenteral nutrition. Follow up study after 2 weeks later showed near complete resolution of IED. IED should be included in the differential diagnosis for unexplained acute chest pain, especially, associated with dysphagia and hematemesis. IED with pneumomediastinum or mediastinitis require prompt surgery. So far, there is no case report of IED combined with pneumomediastinum which resolved without surgical treatment. In this case, IED combined with pneumomediastinum has improved by conservative management, so we present a case report.
