Korean J Gastrointest Endosc.  1998 Apr;18(2):202-210.

Spontaneous Submucosal Dissection of the Esophagus: A case report

• Choi SC
• Lee JI
• Kim WS
• Ryu MS
• Dong SH
• Kim HJ
• Kim BH
• Jang YW
• Jang R
• Lee JY
• Kim SC
• Park JC

Abstract

A 55-year-old male was admitted to our hospital complaining of chest discomfort, dysphagia and severe pain on swallowing. Esophageal manometry identified the lower esophageal sphincter as having no response to swallow. Barium swallow showed typical esophagograms of double barrelled esophagus or mucosal stripe. An endoscopic examination revealed an appearance as if an esophago-tracheal fistula had been made at the level of the upper thoracic esophagus. Also, two slitlike mucosal tears were seen on the lower esophagus. Subsequent fasting and total parenteral nutrition for several weeks failed to bring about any improvement in his symptoms. So, as a treatment, primary closure of the upper opening of the false channel was performed under general anesthesia. Soon after the surgical procedure, the patients symptoms disappeared except for mild dysphagia. He was discharged after oral intake had been judiciously commenced with fluids and soft diets. During his follow-up in the out-patient department, he was examined and found to have no specific symptoms including fever or dysphagia. Moreover, there was great improvement from the massive dissection of the esophagus on esophagogram.

Keyword

Esophageal dissection; Mucosal tear

MeSH Terms

Anesthesia, General
Barium
Deglutition
Deglutition Disorders
Diet
Esophageal Sphincter, Lower
Esophagus*
Fasting
Fever
Fistula
Follow-Up Studies
Humans
Male
Manometry
Middle Aged
Outpatients
Parenteral Nutrition, Total
Thorax
Barium