Korean J Gastrointest Endosc.  2005 Aug;31(2):97-101.

A Case of Spontaneous Submucosal Dissection of the Esophagus Accompanying Mediastinal Abscess

• Choi SJ
• Lee KJ
• Kim YB
• Sim JY
• Lee KM
• Hahm KB
• Kim JH
• Cho SW

Abstract

Spontaneous submucosal dissection of the esophagus (SDE) is a rare disease, in which spontaneous submucosal spot bleeding or intramural hematoma leads to the tearing of the layers between submucosa and muscle of the esophageal wall without any definitive cause, and the pathogenesis of SDE has not been well documented yet. Typical symptoms of SDE are chest pain, hematemesis, dysphagia, and odynophagia. The laboratory tests are usually normal and symptoms could be mild and ambiguous, so the diagnosis of SDE is conducted with endoscopy or esophagogram in most cases. The prognosis of SDE is usually very good with just conservative cares such as fasting and fluid therapy Esophageal perforation complicated by SDE is very rare because symptoms od SDE usually bring the patients to hospital before perforation. Recently, we experienced a case of a 54 year-old male showing the endoscopic findings of SDE and complicated mediastinal abscess probably following esophageal perforation. The patient had social history of chronic heavy alcoholic ingestion and had symptoms of substernal pain, dysphagia, and odynophagia. The patient recovered after partial esophagectomy, abscess drainage and antibiotic therapy.

Keyword

Spontaneous submucosal dissection; Esophagus; Mediastinal abscess

MeSH Terms

Abscess*
Alcoholics
Chest Pain
Deglutition Disorders
Diagnosis
Drainage
Eating
Endoscopy
Esophageal Perforation
Esophagectomy
Esophagus*
Fasting
Fluid Therapy
Hematemesis
Hematoma
Hemorrhage
Humans
Male
Middle Aged
Prognosis
Rare Diseases