Korean J Gastrointest Endosc.  2003 Dec;27(6):527-530.

Endoscopic Treatment of Spontaneous Intramural Dissection of the Esophagus: A Case Report

• Yoon YM
• Park JH
• Hyun DW
• Park CK
• Cho CM
• Tak WY
• Kweon YO
• Kim SK
• Choi YH

Abstract

Intramural dissection of the esophagus is a rare esophageal disorder which reveals characteristic endoscopic and radiologic features. Some authors have recognized that this injury is an intermediate stage between a transmural esophageal rupture (Boerhaave's syndrome) and an esophageal mucosal tear (Mallory-Weiss syndrome). Presenting symptoms are sudden severe retrosternal pain, hematemesis, odynophagia, and dysphagia. The diagnosis is made by contrast esophagography, esophageal endoscopy, or both. Conservative management is usually successful. Surgery should be reserved for the cases of protracted disease or perforation with mediastinitis. We report a case of spontaneous intramural esophageal dissection, in which the symptom of dysphagia did not improve with a conservative management. Then we treated with an endoscopic incision of the septum between the true and false lumens using a needle type papillotome.

Keyword

Esophageal dissection; Endoscopic treatment

MeSH Terms

Deglutition Disorders
Diagnosis
Endoscopy
Esophagus*
Hematemesis
Mediastinitis
Needles
Rupture